A Continuous Quality Improvement Project to Implement Infant-Driven Feeding as a Standard of Practice in the...

Area of Science:

• Neonatal care
• Pediatric nutrition
• Quality improvement in healthcare

Background:

• Neonatal intensive care units (NICUs) face challenges in optimizing feeding practices for timely infant discharge.
• Cue-based feeding strategies aim to improve infant feeding success and reduce hospital length of stay (LOS).

Purpose of the Study:

• To implement and evaluate an Infant-Driven Feeding (IDF) program in a level IV NICU.
• To increase the number of neonates fed according to cues before discharge.
• To potentially decrease the overall length of stay for neonates.

Main Methods:

• A continuous quality improvement (CQI) project was conducted over 13 months in an 85-bed level IV NICU.
• Key interventions included establishing IDF Champions, multidisciplinary team formation, electronic health record integration, staff and patient-family education, and regular team meetings.
• Exclusion criteria focused on neonates requiring significant respiratory support or lacking basic feeding reflexes.

Main Results:

• Baseline data from 20 neonates showed a mean LOS of 43 days.
• Post-implementation data from 150 neonates indicated a reduced mean LOS of 36.4 days.
• The project achieved a potential decrease in mean total LOS by 6.63 days.

Conclusions:

• Infant-driven feeding, utilizing feeding cues, is a viable strategy for promoting successful oral feeding in neonates.
• This approach can be safely applied regardless of gestational age or diagnosis, facilitating earlier discharge.
• Implementing cue-based feeding can lead to significant reductions in neonatal intensive care unit length of stay.