運用Hold住哺乳支托帶提升較大乳房產婦哺餵母乳之滿意度

Increase in satisfaction of breastfeeding mothers with large breasts by using a novel breast support strap

本專案旨在提升較大乳房母乳產婦滿意度。調查較大乳房母乳產婦滿意度僅1.9分，含乳正確性僅30%，護理人員滿意度僅1.7分；而產婦覺得手不夠用、毛巾易滑脫、無法正確含乳及擺位、手扶乳房覺手痠等；護理人員覺得無適當輔具、花費時間長、重複擺位毛巾麻煩、缺乏照護標準等。經創新設計「HOLD住哺乳支托帶」、新增較大乳房母乳產婦照護標準及護理指導單張、新增感應式紅燈、舉辦在職教育、持續品質監測及較大乳房母乳個案出院追蹤等；產婦滿意度提升為3.42分（滿分4分），含乳正確性提升為86%，護理人員滿意度提升為3.48分（滿分4分），故具創意設計的護理輔具，確實可提升整體滿意度，提高母乳哺餵意願，且可作為類似單位參考。

The aim of this study is to increase the breastfeeding satisfaction of mothers with large breasts. According to our self-made satisfaction scale, mothers with large breasts report a mere 1.9 out of 4 total points with a latching accuracy of only 30%. Reasons include needing another person to help, difficulty keeping towels in place, difficulty in maintaining latching and baby position, hand soreness from supporting breasts, etc. Nurse practitioners report a satisfaction rate of 1.7 out of 4 due to lack of supporting devices, excessive time consumption, difficulty placement of towels for support, and lack of standard operating procedure for helping these mothers. We invented a novel breast support strap, established standard operating procedure for nurses, auto-sensing alarms, continued medical education workshops, educational pamphlets, continuous quality assessment, and post discharge follow up for difficulty breastfeeding mothers. After these interventions, breastfeeding satisfaction rate increased to 3.42 out of 4 with latching accuracy up to 85% for these mothers. Nurses report an increased satisfaction rate of 3.48 out of 4. Our novel breast support strap appears to be effective in increasing satisfaction and breastfeeding rate both for mothers and the nurse practitioners who help them.