Evaluation of a Program Aimed at Improving Feeding Outcomes for Infants Receiving Noninvasive Nasal Ventilation

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Introduction: Infants in the neonatal intensive care unit (NICU) often require respiratory support.Nasal ventilation (NV) is preferred over endotracheal ventilation due to fewer adverse effects.Nasal ventilation inadvertently forces air into the stomach, which can precipitate abdominaldistention and feeding intolerance. Due to a perceived increase in instances of abdominaldistention associated with the use of NV, the Mercy Hospital NICU implemented a policychange on January 3, 2022. The goal of the policy change was to expedite achievement of fullenteral nutrition. The benefits of full enteral nutrition include fewer adverse effects related tointravenous (IV) use, improved growth and development, and decreased length of stay. Policychanges included: change in feeding tube product (different length and diameter), delivery offeedings over a shorter duration of time, and intentional evacuation of air from the stomachbetween feedings. Methods: 250 participants were included in this retrospective chart review.The review spanned from six months prior to the policy change date until six months after thepolicy change date. Discussion: Results demonstrate a statistically significant improvement inthe number of days of life from first feed to full feed (p=.0026). There was a decrease in thenumber of times feedings were held, as well as a shorter length of stay in the post policy changegroup. Overall, infants receiving NV in the Mercy NICU achieved full enteral feedings faster andexperienced less exposure to IV nutrition.

DNP Project
Intensive Care Units, Neonatal, Retrospective Studies, Infant, Enteral Nutrition