Quality improvement for neonatal nurses, part II: using a PDSA quality improvement cycle approach to implement an oral feeding progression guideline for premature infants

Area of Science:

• Neonatal care
• Clinical practice guideline implementation
• Quality improvement science

Background:

• Implementing clinical practice guidelines in neonatal intensive care units (NICUs) involving multiple providers is challenging.
• Guideline implementation and evaluation are critical for successful adoption.
• Part I of this series introduced quality improvement concepts and tools.

Purpose of the Study:

• To explore the use of a quality improvement approach for implementing a feeding framework in the NICU.
• To evaluate the effectiveness of a Plan-Do-Study-Act (PDSA) model in guideline implementation.
• To assess parent and care provider satisfaction with the implemented feeding guideline.

Main Methods:

• A Plan-Do-Study-Act (PDSA) quality improvement cycle model was employed.
• Three iterative PDSA cycles were conducted to refine the feeding framework.
• Modifications focused on framework utilization, knowledge translation, and parent education.

Main Results:

• Each PDSA cycle led to adjustments in the feeding framework's application.
• Knowledge translation strategies and parent education tools were developed and refined.
• The iterative process facilitated adaptation and improvement of the guideline.

Conclusions:

• A PDSA cycle approach is effective for implementing and evaluating clinical guidelines.
• This method facilitates collaboration among multidisciplinary health care professionals.
• The approach enhances parent and care provider satisfaction during guideline implementation.