Centre de Collaboration Nationale des Méthodes et Outils

Hi Marc,

Great question! I'm sure this is one that other public health professionals have had as well.

I would like to point you to an earlier discussion thread on our forum where Donna Ciliska identified her "Top 5" databases to search for public health questions.

See: http://www.nccmt.ca/forum/en/topic/39/searching/2.html

I also would like to point you to a great tool available on Health-Evidence.ca's website, "Resources to Guide & Track Your Search". This tool identifies a number of databases to search for each level of the 6S Pyramid of evidence. It also allows you to track the number of results your receive.

Click here to check out this tool: http://health-evidence.ca/tools#tool_12

If other network members have additional tips/ideas - please feel free to share!

Kirsten

This discussion forum is being set up to allow those who have registered for the April 13th webinar to post questions/comments for our two presenters.

To post a question, you will first need to create an account on our site. Visit http://www.nccmt.ca/account/register-eng.html to create a new account. Once you have an account set-up, you will first need to log-in on our site to post a comment (log-in button is located in the top grey toolbar).

Should you have any questions/concerns, please contact Kirsten (searsk@mcmaster.ca).

Kirsten

By email or phone:

Laura Prodanyk, RN, HBScN
Public Health Nurse
Family Health Program
Thunder Bay District Health Unit
999 Balmoral Street
Thunder Bay, ON P7B 6E7
phone 807-625-5952
fax 807-625-4825
email: laura.prodanyk@tbdhu.com

Finally, how can our network members connect with you should they have questions?

[Laura Prodanyk]

In Ontario, following resources to access:

- Ontario Breastfeeding Committee (OBC) http://www.breastfeedingontario.org
- Ontario Breastfeeding Initiative in Community Health Services - see OBC website (link above)
- OPHA Breastfeeding Working Group http://www.opha.on.ca/our_voice/workgroups/breastfeeding.shtml

Outside of Ontario:

- Breastfeeding Committee for Canada http://www.breastfeedingcanada.ca
- RNAO breastfeeding best practice guideline www.rnao.org

Laura, thanks for sharing your story of how the Thunder Bay District Health Unit implemented the BFI practice guidelines and became accredited!

For those that are interested in general information about BFI, what are some good sites they could check out?

[Laura Prodanyk]

Staff required different levels of education and awareness. For those staff that had direct contact with breastfeeding mothers, we provided an 18 hour course or a self-study module and 3 hours of supervised clinical time in our breastfeeding clinic.

For all of our staff, we sent policy information letters, presented at all-staff meetings, staff conferences and staff-recognition events. We had BFI sponsored coffee breaks with prizes. Through emails, posters, giveaways, contests with puzzles and games, a "what you need to know for BFI" cheat sheet that staff could keep at their desks and is now given out at orientation, tent cards with information on the tables in the atrium where people meet, meetings with each program, management meetings, presentations to the Board of Health. When we got close to the external assessment I made binders for the management and CEO's with information at their fingertips.

How did you bring staff 'up to speed' as you implemented BFI across your public health unit?

[Laura Prodanyk]

TBDHU had to consult research evidence in regards to whether there are actual harms associated with formula feeding. As mentioned above, it was new research that made us start looking at formula as risky. INFACT Canada had compiled some of the research and created a pamphlet which we examined. No one in our health unit did a specific literature review on this topic.

We also, examined the topic of harms/benefits associated with co-sleeping/co-bedding. Co-sleeping remains to this day a very hot and controversial topic. Toronto Public Health did a lit review in 2004 or 2005 and many health units used that to inform their practice. We know that many breastfeeding mothers will sleep with their babies and they need to be well informed about the benefits and risks, what the recommendations are, and how they can do it safely if that is what they choose. We are now awaiting a best practice guideline from the Registered Nurses Association of Ontario who has been working on this topic for the last 2 years.

Generally, we have used RNAO’s Breastfeeding Best Practice Guidelines to help inform the messaging and strategies used for BFI in our health unit. Globally, BFI has been well researched and shown to provide positive breastfeeding outcomes and though we didn't use one specific research article or literature review, we were well aware of this global evidence.

While going through the accreditation process, did any questions come up that required your team to look at research evidence?