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Creation of a Standard Model for Tube Feeding at Neonatal Intensive Care Unit Discharge

Benjamin R White1,2, Anna Ermarth1,3, Debbie Thomas4

  • 1Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.

JPEN. Journal of Parenteral and Enteral Nutrition
|September 25, 2019
PubMed

Insights

A new Home Enteral Feeding Transitions (HEFT) program standardizes discharge for neonates needing home enteral nutrition (HEN). This safe and effective approach increases HEN use, improves parental satisfaction, and reduces costs.

Area of Science:

  • Neonatal care
  • Pediatric gastroenterology

Background:

  • Feeding dysfunction is common in neonates, often necessitating nasogastric (NG) or gastrostomy (GT) tubes for home enteral nutrition (HEN).
  • A lack of standardized discharge protocols for infants on HEN poses a challenge.

Purpose of the Study:

  • To implement and evaluate the Home Enteral Feeding Transitions (HEFT) program.
  • To establish a standardized process for identifying eligible patients and managing discharge for infants requiring HEN.

Main Methods:

  • The HEFT program utilized a structured tool for discharge timing and route determination.
  • A dedicated outpatient clinic was established for infants discharged on HEN.
  • Demographic, inpatient, and outpatient data were collected prospectively and compared to a historical cohort.

Main Results:

  • 98 out of 232 infants (42%) were discharged with HEN (68 NG, 30 GT), a 10% increase compared to the historical group.
  • Median length of stay for HEN infants was 31.5 days, with no increase in emergency department visits or admissions related to HEN.
  • Parents reported high satisfaction (8.6/10) and 98% would choose HEN again, with an estimated cost saving of $2163 per NICU day.

Conclusions:

  • The HEFT program is the first known care-process model for HEN utilization at neonatal intensive care unit (NICU) discharge.
  • HEN can be safely and effectively utilized at NICU discharge, demonstrating high parental satisfaction and potential cost savings.
Abstract

Keywords:
neonatesnutritionoutcomes research/quality

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