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Impact of a nurse education programme on oral feeding in a neonatal unit
Anne Beissel1, Angélique Denis2,3,4, Sophie Laborie1
1Neonatal Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.
Insights
An infant-cue based feeding bundle for nurses significantly reduced the time to independent oral feeding (IOF) in preterm neonates. This nurse-driven intervention improves feeding outcomes for premature infants in the NICU.
Area of Science:
- Neonatal care
- Pediatric nutrition
- Quality improvement in healthcare
Background:
- Premature neonates frequently encounter feeding challenges during hospitalization.
- Evidence-based interventions are crucial for enhancing feeding outcomes in this population.
Purpose of the Study:
- To assess if an infant-cue based nurse educational feeding bundle accelerates the achievement of independent oral feeding (IOF) in neonatal intensive care unit (NICU) neonates.
- To evaluate the impact of a structured nurse education program on feeding milestones in premature infants.
Main Methods:
- A quality improvement study utilizing a pre, during, and post-intervention design.
- Involved a four-month nurse training module and ongoing coaching for nurses and nurse assistants.
- Included 706 premature neonates admitted to the NICU.
Main Results:
- The median time to independent oral feeding (IOF) decreased from 40 days (pre-intervention) to 37 days (post-intervention).
- A significant reduction in time to IOF was observed post-intervention (Hazard Ratio = 1.32, 95% CI: 1.01-1.74).
- No significant difference was found in the length of hospital stay across the study periods.
Conclusions:
- An infant-cue based nurse educational feeding bundle effectively promotes earlier achievement of IOF in preterm neonates.
- Nurse-driven, individualized feeding interventions are vital for improving feeding in preterm infants.
- Incorporating such feeding interventions into neonatal critical care nursing education is recommended.
Background:
Premature neonates often experience feeding difficulties during their hospital stay, and evidence-based interventions have been shown to improve feeding outcomes.
Aim:
This study investigated whether an infant-cue based nurse educational feeding bundle accelerates the achievement of independent oral feeding in neonates in a neonatal intensive care unit.
Study Design:
A quality improvement study with a pre, during and post intervention test design. All premature neonates admitted to the unit were eligible. The feeding programme included a four-month nurse training module and nurse coaching.
Results:
A hundred and twenty-five nurses or nurse assistants attended the programme and 706 neonates were included. The median time to independent oral feeding (IOF) was 40, 36 and 37 days, respectively, for pre, during and post intervention. The reduction in time to IOF observed during the post-intervention period compared with the baseline period was significant (HR = 1.32, CI 95%: 1.01-1.74). No difference was noted in the length of hospital stay between the three study periods.
Conclusions:
An infant-cue based nurse educational feeding bundle can promote earlier achievement of IOF in preterm neonates.
Relevance To Clinical Practice:
This quality improvement study demonstrates the impact that a nurse-driven intervention in neonatal care can have on improving practice. Feeding interventions involve the early introduction of oral feeding, non-nutritive sucking (NNS), and oral motor stimulation, and should be individualized for each neonate. These individualized feeding interventions applied by all nurses and assistant nurses, can facilitate the achievement of earlier independent oral feeding in preterm infants and should be included in neonatal critical care nurse education programs.
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