Chest pumping for critically Ill patients: Remaining a breast of best-practices

Abstract

Background and objective: Chest feeding (CF) provides well-documented benefits for both parent and infant, including protection against infection and chronic disease. Despite these advantages, critically ill postpartum patients in the intensive care unit (ICU) face numerous barriers to initiating and maintaining lactation. ICU nurses often report limited training and confidence in supporting CF, placing patients at risk for complications such as engorgement, mastitis, and milk supply failure. The purpose of this quality improvement project was to improve ICU nurses’ knowledge and adherence to evidence-based chest pumping in the care of critically ill, postpartum patients using a structured education session grounded in current best practices.

Methods A quantitative pre-post-intervention design was used. Sixty ICU registered nurses were observed performing 12 standardized chest pumping steps before and after a targeted educational session. Education was delivered at the bedside using a mannequin and supported by visual tools. Data were analyzed using paired-sample t-tests and p-values to evaluate the impact of the intervention.

Results Statistically significant improvements were observed across all 12 steps of the chest pumping process (p <.001), especially in correct pump set-up and hand expression techniques. Several steps reached near or full adherence post-intervention, indicating a strong uptake of the educational content.

Conclusions Targeted bedside education improves CF practices among ICU nurses. It reinforces the role of advanced practice nurses (APNs) in leading practice change and emphasizes the need for ongoing lactation training in critical care environments to support optimal parental and infant outcomes.

Keywords

Chest pumping / Intensive care unit / Nursing education / Postpartum patients / Quality improvement

AUTHORS CONTRIBUTIONS

All authors contributed to the study’s conception and writing. The project was completed by T.M.B, and the original manuscript was completed by T.M.B. The project was supervised by C.G., J.S., and B.V-W. D.B and A.W provided figure production. The manuscript was reviewed, edited, and approved by all authors.

FUNDING

This project does not have any funding sources to disclose.

CONFLICTS OF INTEREST DISCLOSURE

The authors declare that they have no competing interests to declare.

INFORMED CONSENT

Obtained.

ETHICS APPROVAL

The Publication Ethics Committee of the Association for Health Sciences and Education. The journal’s policies adhere to the Core Practices established by the Committee on Publication Ethics (COPE).

PROVENANCE AND PEER REVIEW

Not commissioned; externally double-blind peer reviewed.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

DATA SHARING STATEMENT

No additional data are available.

ACKNOWLEDGEMENTS

We greatly appreciate the contributions of each nurse who participated in our educational intervention.

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