Objective: To analyze the existing risks in breast milk management at the neonatal department and provide corresponding countermeasures. Methods: 22 risk events were identified in 7 risk links in the process of bottle-feeding of breast milk. Hazard Vulnerability Analysis based on the Kaiser model was applied to investigate and evaluate the risk events. Results: High-risk events include breast milk quality inspection, hand hygiene during collection, disinfection of collectors, cold chain management, hand hygiene during the reception, breast milk closed-loop management, and postcollection disposal. Root cause analysis of high-risk events was conducted and breast milk management strategies outside the hospital and within the neonatal department were proposed. Conclusion: Hazard Vulnerability Analysis based on the Kaiser model can identify and assess neonatal breast milk management risks effectively, which helps improve the management of neonatal breast milk. It is conducive to the safe development and promotion of bottle feeding of breast milk for neonates, ensuring the quality of medical services and the safety of children.
Expert Working Group on Revision of Guidelines for Maternal and Infant Populations of the Dietary Guidelines
Revision, Expert Committee of the Chinese Nutrition Society, 2016, Breastfeeding Guidelines for Infants Under Six
Months of Age. Journal of Clinical Pediatrics, 34(04): 287–291.
World Health Organization, 2010, Evidence on Long-Term Effects of Breastfeeding: Systematic Reviews and MetaAnalysis. Systematic Reviews & Meta, 169(1–3): 355–368.
Georgieff M, Piovanetti Y, Queenan J, 1997, Breastfeeding and the Use of Human Milk. Pediatrics, 100(6): 1035–
Zhu Q, Zhao H, Ma L, 2021, Brief Description and Enlightenment of WHO Breastfeeding Consultation Guidelines.
Chinese Maternal and Child Health Research, 32(05): 626–630.
Wei L, Zhu F, Huang C, et al., 2019, Development and Application of NICU Breastfeeding Closed-Loop Information
Management System. Chinese Journal of Nursing, 54(06): 891–895.
Yang P, Shi S, Zhang Y, et al., 2018, Adaptation and Evaluation of Evidence-Based Guidelines for Breastfeeding
of Hospitalized Newborns. Chinese Journal of Nursing, 53(1): 57–64. https://www.doi.org/10.3761/
j.issn.0254-1769.2018.01.011
Yang P, Zhang Y, 2017, Usability Survey of “Evidence-based Guidelines for Breastfeeding of Hospitalized
Neonates”. PLA Nursing Journal, 34(02): 1–6.
Li L, Lian D, Sun J, 2018, Investigation on the Current Situation of Breast Milk and Formula Feeding Management
in NICU. Chinese Journal of Nursing, 53(10): 1199–1205.
Zhang Y, Yang P, Hu X, et al., 2018, Interpretation of the “Evidence-Based Guidelines for Breastfeeding of
Hospitalized Neonates”: Out-of-Hospital Management. Chinese Journal of Modern Nursing, 24(31): 3721–3725.
Zhang Y, Yang P, Hu X, et al., 2018, Interpretation of “Evidence-Based Guidelines for Breastfeeding of Hospitalized
Neonates”: In-hospital Management. Chinese Journal of Modern Nursing, 24(30): 3597–3602.
Yang P, Shi S, Zhang Y, et al., 2018, Adaptation and Evaluation of Evidence-Based Guidelines for Breastfeeding of Hospitalized Newborns. Chinese Journal of Nursing, 53(01): 57–64.
Shi S, Zhang Y, 2015, Multi-Center Survey on Breastfeeding Management of Hospitalized Newborns. Journal of Nursing, 30(11): 32–35.
Zheng S, Xu L, 2021, Problems and Countermeasures in Hospital Disaster Vulnerability Analysis. China Health Quality Management, 28(03): 69–71. https://www.doi.org/10.13912/j.cnki.chqm.2021.28.3.21
Zhao D, Liu Z, He S, et al., 2016, Preliminary Study on Hospital Disaster Vulnerability Concept and Evaluation Method. Chinese Disaster Relief Medicine, 4(09): 520–523. https://www.doi.org/10.13919/j.issn.2095-6274.2016.09.012
Feng X, Zheng X, Qian X, et al., 2022, Surgical Nursing Risk Management in Tertiary Hospitals Based on Disaster Vulnerability Analysis. Nursing and Rehabilitation, 21(05): 42–45 + 48.
Feng X, Wang L, Chen J, 2022, Nosocomial Infection Risk Assessment in Neonatology Based on Disaster Vulnerability Analysis. Chinese Journal of Hospital Management, 38(01): 56–59.
Li S, 2021, Analysis of Hospital Logistics Disaster Vulnerability Based on the Kaiser Model. Modern Hospital,21(10):1551–1553.
Yu M, Zhang Q, Yang Q, et al., 2020, Construction of New Coronavirus Pneumonia Prevention and Control Strategies in Specialized Hospitals Based on Disaster Vulnerability Analysis. Chinese Journal of Nursing, 55(S1): 189–192.
Medical Center Hazard and Vulnerability Analysis, n.d., viewed March 1, 2020, https://www.cabq.gov/office-of-emergency-management/documents/KaiserMedCenterHVA.pdf
He F, Deng Y, Lin Y, et al., 2020, Reconstruction of the Feeding Process Based on Evidence-Based Guidelines for Bottle Feeding with Breast Milk for Hospitalized Newborns. Journal of Nursing Management, 20(06): 423–428.
Zhao Y, Zhang X, Gu Y, et al., 2020, Construction of Closed-Loop Breast Milk Bank Management System in Neonatal Ward. Journal of Hospital Management, 2020(02): 169–172.
Sun L, Yu X, Chen J, et al., 2018, Design and Application of a Breastfeeding Closed-Loop Management System Based on HIMSS Level 7. Journal of Nursing, 25(17): 45–49. https://www.doi.org/10.16460/j.issn1008-9969.2018.17.045
Xiong Y, Wu X, Wang L, et al., 2015, Using Modern Information Technology to Achieve Closed-Loop Management of Breastfeeding. Chinese Nursing Management, 15(08): 933–935.
Zheng X, Zhou X, Ma J, et al., 2015, Research and Practice of Patient Clinical Security Information Assurance Based on Closed-Loop Medical Orders. Chinese Hospital Management, 35(08): 26–28.