Breast Pump Returns One Piece of the Puzzle

Objectives • Understand what Chapter 19 says about breast pump returns • Understand the process of breast pump returns in HANDS

Breast Pump Returns & Chapter 19 Policy

Why Would a Mom Return a Pump? • Mom is no longer using the pump • Mom has reached her breastfeeding goal & doesn’t need the pump anymore • Mom stopped breastfeeding • Pump is long overdue v Reference Chapter 19 -9: Breastfeeding Assessment Category Change

Pump Return Flow Mom returns a pump Mom and baby have a change in feeding needs, they may need a category change Mom and baby do not have a change in feeding needs Mom is dropping off an overdue pump Mom and baby require a Breastfeeding Assessment Accept pump and proceed with return process

What Would You Do? • Mom comes to the front desk and says she is returning her breast pump. She tells you she isn’t making enough breast milk and because of this, she wants to stop breastfeeding and start formula. v Reference Chapter 19 -29, 30: Section E Arizona WIC Peer Counselor Program

Remember! • If a mom is changing the way her baby is being fed, a Breastfeeding Assessment must be completed by a Designated Breastfeeding Expert (DBE) • Many moms may continue breastfeeding or pumping after having their questions answered v Chapter 19 -9: Breastfeeding Hotline

Breastfeeding Support Staff: Levels These breastfeeding services are defined as: • Level 1 – Pregnancy education (any trimester), general breastfeeding education and follow-up, pump issuance, breastfeeding assessment without concerns/complications • Level 2 – Breastfeeding issues/concerns, complications with a referral, emergency pump services, breastfeeding assessments with tailoring due to breastfeeding concerns • Level 3 – 602/603, complications and/or trauma v Chapter 19 - Section B pg. 12 -13: Breastfeeding Education & Support Training-Staff

Chapter 19 Breastfeeding Assessment: Category Change • A breastfeeding assessment shall be conducted at each appointment for a breastfeeding dyad or if there is a change in category or in feeding needs. v Reference Chapter 19 -9: Breastfeeding Assessment: Category Change

Chapter 19 Breastfeeding Assessment: Documentation • The breastfeeding assessment shall be documented in the Assessment screen and in the Notes screen using the TGIF format and include the – reason for the change, – education given, – amount of breastfeeding and the number of cans of formula issued if applicable. v Reference Chapter 19 -15: Documentation: Individual Participant Breastfeeding Education

Chapter 19 Process of Return: Hospital-Grade Pump 1. In the participant file, update the status in the Breast Pump Issuance and Return Screen as Returned. 2. Verify that the pump icon in the active record is deactivated. 3. Fill out the Breast Pump Receipt for Return of Hospital-Grade Double Electric Breast Pump. Remove the white copy (top) scan and save in the clients file in HANDS; the participant receives the pink copy (2 nd copy), leave the remaining yellow copy (3 rd copy) in the receipt booklet, Chapter 19 (Appendix B). 4. Follow the appropriate cleaning procedure for all pumps. 5. Update the status to Available when the pump is ready to be returned to current clinic inventory. v Reference Chapter 19 -21: Process of Return: Hospital Grade Pump

Other Circumstances – Broken Pump is broken or malfunctioning Accept pump and evaluate for efficiency

Chapter 19 Quality Assurance – Breast Pumps Efficiency Testing 1. Assemble the pumping kit for single pumping. Cover the hole for the unused side. 2. Attach it to the breast pump. 3. Attach the vacuum gauge to the breast shield. 4. Turn the suction to LOW/MIN and read the value. • 5. Hospital-Grade Pump: ~ 50 mm. Hg Turn the suction to HIGH/MAX and read the value. • Hospital-Grade Pump: ~ 270 mm. Hg

Chapter 19 Malfunctioning or Broken Hospital-grade Breast Pump 1. In the active record, select the client. Use the Navigation Pick List and select Pump Issuance and Return. Change the status to Returned. Exit the client file. 2. From the WIC Services screen, use the Navigation Pick List and select Pump Issuance and Return. Enter and search the pump serial number. Update the pump status in HANDS as Broken and save. 3. Document the problem with the pump in the Comments section of the Pump screen. Examples include arm not moving, cord frayed, not maintaining suction.

Chapter 19 Malfunctioning or Broken Hospital-grade Breast Pump 4. Remove the pump from the case. 5. Return both case and pump as they are both being collected and replaced. 6. Place pump in a shipping box. 7. Contact the ADHS Warehouse for a return authorization number and prepaid shipping label.

Chapter 19 Malfunctioning or Broken Hospital-grade Breast Pump 8. Provide the Warehouse staff with the Hospital-Grade Breast Pump Request for Repair form (see Appendix B) and include: a. Contact person's name b. Agency name c. Address d. Phone number e. Email f. Reason for the return 9. Ship or hand-deliver the pump to ADHS v Reference Chapter 19 -23: Malfunctioning or Broken Hospital-grade Breast Pumps

Other Circumstances – Transfers -Mom brings pump back to your clinic -She is from a different agency -She wants to transfer to your clinic -Transfer mom -Pump will transfer with mom -Proceed with usual services

Other Circumstances – Transfers -Mom brings pump back to your clinic -She is from a different agency -She does not want to transfer to your clinic -Do not transfer mom -Accept returned pump -Contact the WIC Service Desk to add pump to your agency’s inventory

Breast Pump Returns in HANDS

Two Options for Returning a Pump in HANDS 1. Via WIC Services Search Screen 2. Via Client Screen

Option 1: Via WIC Services Search Screen Start at WIC Services Search Screen Access Breast Pump Issuance and Return via Side Navigation Menu

Via WIC Services Search Screen

Option 2: Via Client Screen Start at mother’s active record Access Breast Pump Issuance and Return via Side Navigation Menu

Via Client Screen

Via Client Screen Edit Change Status

Via Client Screen

Breast Pump Issuance and Return Screen

Breast Pump Issuance and Return Screen Actual Return Date

Breast Pump Issuance and Return Screen Comment Box

Breast Pump Issuance and Return Screen

Breast Pump Icon • After a pump is returned in HANDS, the breast pump icon will no longer display Before Return After Return

What Would You Do? • Mom comes to the front desk and says she is returning her breast pump. She tells you she isn’t making enough breast milk and because of this, she wants to stop breastfeeding and start formula. v Reference Chapter 19 -29, 30: Section E Arizona WIC Peer Counselor Program

Local Agency Policy and Procedures • It is important to also follow your Local Agency Policy and Procedures when returning a pump • Discuss local agency pump returns with your Supervisor or Breastfeeding Coordinator