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researched seemed to support what the student thought should be the best practice. One article stated, “Breastfeeding during painful procedures, such as heelstix or venepuncture, has a significant analgesic effect.” (Appleyard, L.:2014). The article also explains that all of the senses engaged in newborn during breastfeeding, contribute to this analgesic effect (Appleyard, 2014). The students and I were also concerned with the fact that these infants are receiving the sucrose with a pacifier. According to the Baby-Friendly USA website as one of the ten steps to successful breastfeeding is no pacifiers are to be given to breastfed newborns (Baby-Friendly USA 2013). This is well-supported by the policy of American Academy of Pediatrics that “pacifiers should not be used with breastfeeding infants until breastfeeding is well established after about 3-4 weeks.” ( 2012, p.e834). As the educator of the new generation of Master’s prepared nurses it is important and my responsibility to be that role model with looking at the evidence and implementing a change to the clinical practice. Stakeholders are an important consideration when implementing a change in practice. They are the group that are most impacted by the proposed change in practice in the healthcare setting. The stakeholders directly involved in this change at Franklin Square hospital’s Mother-
TRANSLATIONAL RESEARCH FOR PRACTICE & POPULATIONS4baby unit involve patient/family, nurse manager, nurse educator, bedside clinical nurse, nurse support tech., and the lactation team of nurses. The patient/familyconsists of the mother, the newborn and family members. They all have a role in this practice change. The mother has the role of primary care provider for the newborn. They need to give the consent for the IM injection or heel lance, while also taking part in assisting the nurse with pain evaluation and being a part of the non-pharmacological method of pain (holding and breastfeeding). TheNurseManagertakes on supporting the practice change and bringing it to the policy team. Their role as manager is to give the staff the motivation and support to bring about a change in practice. Managers hopefully detect any barriers that could hinder and limit the staff to change. Each unit has a Nurse Educator. They are the experts on educating the staff on the evidence- based research and the skills needed to bring about a positive attitude towards the nursing practice change. They also have the responsibility to keep the competency skills for this change up to date and make sure all nurses stay competent in the skill. Bedside Clinical Nurse is the advocate for the patient. The patient develops a trust in nurse/patient relationship. The bedside nurse needs to educate the patient on the evidence-based literature that supports her nursing practice. They need to be competent in their new skill and have an attitude that is positive towards the change. There is a Nurse Care Associateon the floor who is assigned to a nurse fora shift. Their role is to carry out the actually heel lances for blood collection. For this practice change they would need to learn how to do the skill while baby is breastfeeding on mother and be comfortable in that skill.