title: Healthcare quality in breastfeeding: implementation of the nipple trauma index.
abstract: OBJECTIVE
  assess the efficacy of the Nipple Trauma Indicator Instrument implemented in the rooming-in facility t of a university teaching hospital as a healthcare quality indicator.
  
  
  METHODS
  exploratory, descriptive, retrospective study, with analysis of the Nipple Trauma Indicator tool of 1,691 mothers admitted in rooming-In from June to November 2012. Data were presented as absolute frequencies and percentages and statistical tests were administered.
  
  
  RESULTS
  the mean rate of nipple trauma was 55.5%. The most frequent trauma was excoriation (62,2%) and the main cause was incorrect attachment of the newborn (44%). Maternal and neonatal factors associated with nipple trauma are also presented.
  
  
  CONCLUSIONS
  the Nipple Trauma Indicator provides a picture of breastfeeding healthcare, contributing to the construction of this quality indicator.
authors.affiliation: Universidade de São Paulo (USP), Hospital Universitário, Departamento de Enfermagem. São Paulo, São Paulo, Brasil.
authors.forename: Michelli Oliveira Vani
authors.initials: MO
authors.lastname: Cirico
authors.affiliation: Universidade de São Paulo (USP), Hospital Universitário, Departamento de Enfermagem. São Paulo, São Paulo, Brasil.
authors.forename: Gilcéria Tochika
authors.initials: GT
authors.lastname: Shimoda
authors.affiliation: Universidade Municipal de São Caetano do Sul. São Caetano do Sul, São Paulo, Brasil.
authors.forename: Rebeca Nunes Guedes de
authors.initials: RN
authors.lastname: Oliveira
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding; D005260:Female; D006801:Humans; D009558:Nipples / Q000293:injuries*; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000453:epidemiology / Q000628:therapy; D055815:Young Adult