Page 14 - Delaware Medical Journal - June 2017

Improving Growth Velocity through
Implementation of a Standardized Feeding Protocol for Very Low Birth Weight Infants
Julia D. Ryan, MD; Deborah Tuttle, MD; Robert Locke, DO, MPH; Amy Mackley, MSN, RNC;
David A. Paul, MD
Objective: To determine if implementation of a performance improvement initiative including a standardized feeding protocol in a large level 3 Neonatal Intensive Care Unit (NICU) improves growth velocity in very low birth weight infants.
Methods: A standardized feeding protocol was developed by a multidisciplinary team. During the six-month pre-intervention phase, data were collected on all infants with birth weight <1500 grams and <34 weeks. Following a period of intensive education of both nursing and medical teams, the protocol was implemented, and data were collected on the same population of infants born during the following six months.
Results: There were 108 infants included in the analysis with 49 in the pre-intervention and 59 in the post-intervention phases. Day of life to full feeds and total parenteral nutrition (TPN) days were not different between the groups. Mean growth velocity improved by 2.0 grams/d. Additionally, the number of line days and occurrence of sepsis did not differ pre- or post-intervention.
Conclusions: Implementation of a standardized feeding protocol improved growth velocity without changes in balancing measures. There may be potential improved feeding process measures not tracked in our study, such as reduced provider practice variation, consistent expectation of nurses, medical team, and nutrition services, and improved satisfaction of families.
174 Del Med J | June 2017 | Vol. 89 | No. 6
Abstract