Standardised Feeding Approach Improves NICU Babies' Growth
Many infants have complicated feeding difficulties and changes in clinical caregivers throughout their hospital stay. The researchers hypothesised that a standardised approach to feeding could eliminate variability and simplify the transitions from enteral feeding to full oral feeding (milk by mouth without tubes or limitations).
The research team collected baseline data from 92 infants before initiating their quality improvement study with another 92 infants they enrolled in their SIMPLE (simplified, individualised, milestone-targeted, pragmatic, longitudinal and educational) programme. This specific programme involved analysing critical aspects of institutional processes, building consensus, developing educational workshops, monitoring compliance and accountability and providing constant feed-forward information.
“Our SIMPLE feeding approach resulted in improved growth, eventually leading to more time at home with parents,” says Sudarshan R. Jadcherla, MD, principal investigator in the Innovative Feeding Disorders Research Programme at Nationwide Children’s. “The emphasis of our programme was on implementation of guidelines that can still be tailored to the infant’s and parent’s individual needs.”
Babies on the SIMPLE feeding programme spent significantly less time on trophic feeds, which stimulate the gut but do not provide sufficient nutrients for growth, and less time being tube-fed. They were also able to tolerate the introduction of oral feeds and exclusive oral feeding earlier than babies prior to the guideline implementation. The research team credits this improved feeding trajectory with the greater daily weight gains achieved by babies on the SIMPLE plan, which in turn led to stays of about 15 days shorter duration.
"The length of stay was reduced while balancing measures and co-morbidities such as necrotising enterocolitis, chronic lung disease, mortality and readmission rates remained similar or trended downward,” explains Dr. Jadcherla, who also is a principal investigator in the Center for Perinatal Research in The Research Institute and a professor of paediatrics at The Ohio State University College of Medicine.
There are no accepted benchmarks for feeding babies in an all-referral NICU, where admission requirements and sickness levels can be heterogeneous. Dr. Jadcherla founded the concept of the SIMPLE plan, developed the core group, trained feeding providers and led a multidisciplinary team of NICU caregivers in this quality improvement endeavour.
The team hopes the programme’s success at Nationwide Children’s will be obtainable by other hospitals, as well. “The guidelines were designed with an understanding of infant development, aerodigestive reflexes and individual clinical needs that will be adaptable to any NICU population,” according to Dr. Jadcherla. “The SIMPLE feeding programme also provides a forum for regular collaboration in regards to feeding management, which will help other institutions easily incorporate it into their care efforts.”
Source: Nationwide Children's Hospital
Image Credit: Flickr.com
Published on : Thu, 5 Mar 2015
Print as PDF
NovaPort cannulas are designed specially to meet the needs of extracorporeal lung and heart support circuits and perioperative perfusion in minimally invasive heart surgery.All blood-contact surfaces of the NovaPort cannulas are coated with the bio- and...
The HAMILTON-C6 represents a new Generation of high-end ventilators. The combination of modularity, ease of use, mobility, and advanced features allows you to individualize your patient's ventilation therapy: - State-of-the-art ventilation modes for adult,...
The fully featured ICU ventilator, HAMILTON-MR1, guarantees uncompromised continuous ventilation care from the ICU to the MRI scanner and back. Its reliability and high performance, with advanced lung-protective strategies and patient-adaptive modes,...
The HAMILTON-C3 ventilator is a modular high-end ventilation solution for all patient groups. Offering a number of unique features, the HAMILTON-C3 is one of the first ventilators featuring the “Ventilation Autopilot” INTELLiVENT-ASV®. The HAMILTON-C3’s...
The iLA Membrane Ventilator is an extrapulmonary ventilation system which is used primarily to remove carbon dioxide. The heart pumps blood through it as it does through a natural organ. The gas exchange takes place via a plasma-tight, heparin-coated...