Psychometric Validation of the Family Nurse Caring Belief Scale in a Neonatal Nursing Population.

PURPOSE: To psychometrically validate and strengthen the construct validity of the Family Nurse Caring Belief Scale (FNCBS) with a sample of neonatal nurses. DESIGN AND METHODS: Confirmatory factor analysis of the 25-item FNCBS, using the factor structure based on the original exploratory principal components analysis, was performed to evaluate the psychometric properties of the FNCBS with the neonatal nurse population. RESULTS: Confirmatory factor analysis (CFA) examined the factor structure of the FNCBS using the sample of neonatal nurses. The chi-square test determined overall model fit. Comparative fit index (CFI) and Tucker-Lewis index (TLI) were both <0.90 therefore, neither of these indices indicated good fit. The root mean square of error approximation (RMSEA) of the sample data was >0.06 and the standardized root mean square residual (SRMR) of the sample data is >0.08 and, therefore, the data did not demonstrate good fit. In addition, the factor correlations between the four latent variables were small. This suggests there is no parsimony and the sample data with neonatal nurses did not fit the model. CONCLUSION: The findings suggest the FNCBS was not psychometrically validated with the population of neonatal nurses and this study was unable to strengthen the construct validity of the FNCBS beyond the pediatric nurse sample in the original study. IMPLICATIONS FOR PRACTICE: This study highlighted the opportunity for continued research in the area of measuring nurses' beliefs regarding the provision of family-sensitive care to families in crisis and will generate a revision of the FNCBS to incorporate concepts which are important to care for a family unit.

Transforming a care delivery model to increase breastfeeding.

This article describes the process of changing the care delivery model for maternity practice in a New York State Regional Perinatal Center to support exclusive breastfeeding, defined as providing nothing other than human milk feedings. Barriers exist in hospitals that inhibit exclusive breastfeeding of newborns at the time of discharge and fail to meet the recommendations outlined by the World Health Organization and New York State Department of Health. All aspects of mother/baby care were evaluated to meet the recommendations and increase exclusive breastfeeding. Transforming the care delivery model for mothers and babies began in 2010 with an invitation to participate in the New York State Breastfeeding Quality Improvement in Hospitals Learning Collaborative. Twelve hospitals were selected to participate with the following objectives: increase exclusive breastfeeding; improve hospital breastfeeding policies, practices, and systems that are consistent with New York State hospital regulations, laws and recommended best practices; increase staff skills and knowledge of breastfeeding and lactation support through education; empower, educate, and support new mothers to successfully breastfeed and change the culture and social norm relative to breastfeeding. The transformation of the care delivery model resulted in an increase in exclusive breastfeeding from 6% to 44%.