Quality improvement initiative to decrease time to full feeds and central line utilization among infants born less...

Area of Science:

• Neonatalogy
• Pediatric Gastroenterology
• Quality Improvement in Healthcare

Background:

• Emerging evidence supports more aggressive feeding advancement in preterm infants.
• Previous conservative guidelines in our NICU delayed enteral feeding and prolonged central line use.
• A need existed to optimize feeding protocols for infants born ≤32 0/7 weeks gestation.

Purpose of the Study:

• To implement evidence-based, faster feeding advancement guidelines.
• To reduce the time to full enteral feeds for preterm infants.
• To decrease central line utilization and assess impacts on NEC and EUGR.

Main Methods:

• A multidisciplinary team adopted quality improvement methodologies.
• New evidence-based feeding guidelines were implemented.
• Key outcomes analyzed included days to full enteral feeds, central line days, NEC rates, and EUGR rates.

Main Results:

• Average days to full enteral feeds decreased from 12.8 to 7.7 days for infants ≤32 0/7 weeks.
• Average days to full enteral feeds decreased from 17.5 to 9.1 days for infants ≤28 0/7 weeks.
• Central line days reduced by 35% without a significant increase in NEC or EUGR rates.

Conclusions:

• Faster feeding advancement guidelines effectively accelerated achievement of full enteral feeds.
• The updated guidelines successfully reduced central line utilization.
• The study demonstrated that accelerated feeding protocols can be implemented safely, without increasing major complications.