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J Obstet Gynecol Neonatal Nurs · Sep 2015
A Continuous Quality Improvement Project to Implement Infant-Driven Feeding as a Standard of Practice in the Newborn/Infant Intensive Care Unit.
- Kimberly A Chrupcala, Taryn M Edwards, and Diane L Spatz.
- J Obstet Gynecol Neonatal Nurs. 2015 Sep 1; 44 (5): 654-64.
ObjectiveTo increase the number of neonates who were fed according to cues prior to discharge and potentially decrease length of stay.DesignContinuous quality improvement.SettingEighty-five bed level IV neonatal intensive care unit.PatientsSurgical and nonsurgical neonates of all gestational ages. Neonates younger than 32 weeks gestation, who required intubation, continuous positive airway pressure (CPAP), high flow nasal cannula (HFNC), or did not have suck or gag reflexes were excluded as potential candidates for infant-driven feeding.Intervention/MeasurementsThe project was conducted over a 13-month period using the following methods: (a) baseline data collection, (b) designation of Infant Driven Feeding (IDF) Champions, (c) creation of a multidisciplinary team, (d) creation of electronic health record documentation, (e) initial staff education, (f) monthly team meetings, (g) reeducation throughout the duration of the project, and (h) patient-family education.ResultsBaseline data were collected on 20 neonates with a mean gestational age of 36 0/7(th) weeks and a mean total length of stay (LOS) of 43 days. Postimplementation data were collected on 150 neonates with a mean gestational age of 36 1/7(th) weeks and a mean total LOS of 36.4 days. A potential decrease in the mean total LOS of stay by 6.63 days was achieved during this continuous quality improvement (CQI) project.ConclusionsNeonates who are fed according to cues can become successful oral feeders and can be safely discharged home regardless of gestational age or diagnosis.© 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.
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