The process of implementing a new baby-friendly hospital initiative for nurses: a grounded theory study

Maternity nursing practice is changing across Canada with the movement toward becoming “baby friendly.” The World Health Organization (WHO) recommends the Baby-Friendly Hospital Initiative (BFHI) as a standard of care in hospitals worldwide. Very little research has been conducted with nurses to explore the impact of the initiative on nursing practice. The purpose of this study, therefore, was to examine the process of implementing the BFHI for nurses. The study was carried out using Corbin and Strauss’s method of grounded theory. Theoretical sampling was employed, which resulted in recruiting and interviewing 13 registered nurses whose area of employment included neonatal intensive care, postpartum, and labour and delivery. The data analysis revealed a central category of resisting the BFHI. All of the nurses disagreed with some of the 10 steps to becoming a baby-friendly hospital as outlined by the WHO. Participants questioned the science and safety of aspects of the BFHI. Also, participants indicated that the implementation of this program did not substantially change their nursing practice. They empathized with new mothers and anticipated being collectively reprimanded by management should they not follow the initiative. Five conditions influenced their responses to the initiative, which were (a) an awareness of a pro-breastfeeding culture, (b) imposition of the BFHI, (c) knowledge of the health benefits of breastfeeding, (d) experiential knowledge of infant feeding, and (e) the belief in the autonomy of mothers to decide about infant feeding. The identified outcomes were moral distress and division between nurses. The study findings could guide decision making concerning the implementation of the BFHI.

The effect of note taking on memory for details in investigative interviews

Across 3 experiments, the effect of different styles of note taking, summary and access to notes was examined for memory for the details contained in a witness interview. In Experiment 1, participants (N = 40) were asked to either take notes or listen as they watched a witness interview. In Experiment 2, participants (N = 84) were asked to either take notes in one of three ways (i.e., conventional, linear, spidergraph) or listen as they watched a witness interview. In Experiment 3, participants (N = 112) were asked to take notes using the conventional or spidergraph method of note taking while they watched a witness interview and were subsequently given an opportunity to review their notes or sit quietly. Participants were then either granted access to their notes during testing or were not provided with their notes. Results of the first two experiments revealed that note takers outperformed listeners. Experiment 2 showed that conventional note takers outperformed those who used organizational styles of note taking, and post-hoc analyses revealed that recall performance was associated with note quality. Experiment 3 showed that participants who had access to their notes performed the best. The implications of these findings for police training programs in investigative interviewing are discussed.