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Staffing Your Hospital Infant Feeding Preparation Room

Hospitals are increasingly recognizing the value of using dedicated staff within a centralized location for human milk (HM) and formula preparation to reduce risk of contamination and preparation errors.  The key is getting the right staff in place to perform this important function.

Bottle being prepared for fridge

Why use dedicated staff?

  1. Use of dedicated staff allows them to focus solely on feeding preparation without other distractions and patient care duties.
  2. Published data supports that the use of dedicated technicians for feeding preparation improves patient safety by reducing frequency of errors.1,2,3
    • In a six-year analysis of a 114-bed neonatal intensive care unit (NICU), wrong HM, expired HM, and wrong fortifier scans when their bedside nurses were preparing feedings were compared to wrong scans when dedicated technicians were preparing feedings. Researchers found that incorrect scans per 1,000 bottles decreased from 97 to 14 when dedicated technicians were utilized.1
    • A review within a level IV NICU found that wrong HM or wrong fortifier scans decreased by 88% when feeding preparation responsibilities were moved from the bedside nurse to dedicated technicians.2
    • A seven-year review in a 104 bed level IV NICU found that 75% of wrong HM scans occurred at the bedside.3
  3. Use of technicians for feeding preparation provides the bedside nurse additional time to focus on direct patient care duties including assisting parents with skin-to-skin and direct breastfeeding. It also allows registered nurses to work at the top of their scope.

Education and skills

Many hospitals are unsure of where to start to find appropriate candidates.  The goal of an infant feeding preparation operation is to provide safe and accurately prepared human milk and formula feedings to the right patient at the right time.  While there is not a uniform job description or educational requirement for an infant feeding preparation technician at this time, to accomplish this goal the candidate should have a skill set that includes:4

  • Knowledge of infection control measures and aseptic technique
  • Understanding of proper handling of HM and formulas
  • Critical thinking skills
  • Basic math skills
  • Attention to detail
  • Good written and verbal communication
  • Strong time management skills

The level of formal education required will depend on the scope of the preparation operation, the level of supervision, and the amount of on-the-job training available.  A hospital utilizing staff with some sort of healthcare technical education will likely be able to have their technicians operate with greater autonomy and less training.  Those employing technicians with a high school diploma will likely need a more robust training program and greater oversight of day-to-day operations.

Syringes with breast milk for tube feeding

Many hospitals choose to require staff to have some sort of formal technical healthcare degree/license.  The benefit of such training and experience is that these candidates are likely already familiar with the hospital environment, general medical terminology, and aseptic technique.  When available, the dietetic technician, registered (DTR) makes an excellent candidate for an infant feeding preparation technician because the focus of the training is on nutrition, food handling, and aseptic technique.  Individuals may take the dietetic technician registration exam after completing either an associate’s degree from an accredited dietetic technician program which includes 450 hours of clinical supervised practice or a bachelor’s degree from an accredited nutrition and dietetics program.  DTRs must complete 50 continuing education credits every 5 years to maintain registration.  Some regions have easy access to DTR candidates due to an abundance of local educational programs while other parts of the country do not have such programs, making candidates with this type of education more difficult to find.  In addition to the DTR, there are several other healthcare disciplines that make a good fit for an infant feeding preparation technician.  Such examples could include:

  • Pharmacy technician
  • Medical technologist
  • Certified nursing assistant (CNA)
  • Licensed practical nurse (LPN) or licensed vocational nurse (LVN)
  • Certified dietary manager (CDM)

Another option is to seek college students majoring in healthcare professions, particularly nutrition or nursing.  The benefit of hiring students in these disciplines is that they may have already received quite a bit of education that would be relevant to the position and are often very interested in gaining healthcare experience.  Students may be eager to fill hard to cover shifts such as evenings, weekends, and holidays.  However, when selecting students, one must consider the cost of training due to frequent turnover as students move on to pursue positions within their studied professions.

Selecting non-technical staff from within an organization can still have benefits.  Internal candidates have a knowledge of the organization and may have some familiarity with some of the hospital computer systems.  Some examples of internal candidates could include:

  • Food service employees: Knowledge of aseptic technique and proper food handling.
  • Supply chain employees: Knowledge of products, ordering, and hospital units.
  • Sterile processing employees: Knowledge of aseptic technique.
  • Unit support or nursing assistants: Knowledge of aseptic technique, hospital units, and hospital computer systems.

Regardless of the education level of candidates selected, internal training is crucial and should include didactic and active (hands-on) learning.  Concepts such as infection prevention, infant nutrition, and lactation may be covered through lectures and modules.  Order transcription/interpretation and math calculations should be taught, practiced, and tested to ensure competency.4  Hands-on simulation of aseptic technique and feeding preparation is helpful to ensure realistic learning.4   Training may be created internally or the hospital may choose to utilize one of the existing infant feeding preparation technician programs.5,6

Ensuring proper selection and training of infant feeding preparation technicians is critical for the safety and success of a centralized preparation room.  Published resources can make the task easier, but don’t hesitate to seek expert guidance along the way.

References

  1. Oza-Frank R, et al. A Quality Improvement Project to Decrease Human Milk Errors in the NICU.  Pediatrics.  2017;139(2).  DOI: 10.1542/peds.2015-4451.
  2. Alessi S, Rengifo J, Steele C, Kaur G, Desai P. Improving Comprehensive Enteral Feeding Handling Processes in a Level 4 NICU: A Quality Improvement Project.  Pediatric Academic Societies Abstract April 2023.
  3. Steele C, Bixby C. Bar Code Scanning of Human Milk and Enteral Formulas Improves Efficiency and Patient Safety: A 7-Year Review Nutrition in Clinical Practice.  2021;1-8.  https://doi.org/10.1002/ncp.10765
  4. Steele C, Collins E, eds. Infant and Pediatric Feedings: Guidelines for Preparation of Human Milk and Formula in Health Care Facilities. 3rd ed. Chicago, IL: Academy of Nutrition and Dietetics; 2018.
  5. Ohio State University. Infant Feeding Technician Certificate Course.   https://foodindustries.osu.edu/infant
  6. Columbus State Community College. Formula / Human Milk Technician Certificate Program https://www.cscc.edu/for-business/formula-tech.shtml

Learn more about Timeless Medical Systems

Timeless Medical Systems now offers preparation room consulting services covering many aspects including equipment and layout design, FTE calculations, training and certifications for prep room technicians, and even creating daily workflows to optimize efficiencies. Our very experienced and skilled Clinical Team Members have 1st hand experience in creating and implementing centralized preparation rooms and processes in some of the largest most prestigious hospitals throughout North America. If you are interested in learning more about these consulting services, please contact sales@timelessmedical.com.

The material presented in this blog represents the opinion of the author(s) and not necessarily the views of Synova Associates. Synova Associates does not endorse any specific products or organizations but strives to connect its industry partners with leaders interested in product/educational innovation.