Refining clinical terminology for expert system development: an application in the neonatal intensive care unit

To clarify terms surrounding the clinical problem of initiating oral feeding in premature infants cared for in the neonatal intensive care unit (NICU). Understanding terminology at the outset of expert system (ES) development forms the crucial foundation needed to build a system that is accurate, relevant, and useful for assisting clinicians.

Ethnographic methods were used. In phase 1 participant observation with an interdisciplinary neonatology team was used to study oral feeding for premature infants. In phase 2 in-depth interviews were conducted with a neonatal nurse practitioner (NNP) to explore feeding terms and the description and understanding of these terms.

Results showed that oral feeding was a complex term that encompassed several feeding options; specifically nipple, breast, gavage, and transpyloric feeding.

Each of the terms had a specific meaning within the context of the NICU.