Abstract
Background: The incidence of neonatal abdominal wall defects, such as gastroschisis, has been increasing. There remains a need for best practice guideline for postsurgical care.|Purpose: The purpose of this quality improvement project was to develop an evidence-based postsurgical feeding guideline for infants of more than 34 weeks’ birth gestational age or more than 1500 grams birth weight with gastroschisis.|Methods: Through review of literature for postsurgical gastroschisis, feeding approaches that appeared to be associated with improved patient outcomes were utilized in developing an evidence-based feeding guideline. A retrospective chart review was completed for 20 infants diagnosed with gastroschisis from 2 level III-IV neonatal intensive care units in the Mountain Region of the United States to describe current practice and to better inform the development of post-surgical feeding guidelines.|Results: Postsurgical care approaches in the literature that were associated with improved patient outcomes included earlier introduction of enteral feedings, timing of feeding, volume of feeding, and fortification of feeding. Chart review indicated that there were differences in the rate of progression, how infants were fortified, degree of illness, and complexity of infant status.|Conclusion: The evidence-based feeding guideline for post-surgical infants with gastroschisis may provide improved patient outcomes, such as survival and hepatic function, shorter length of hospitalization, and care provider satisfaction and standardization of practice.|Keywords: Gastroschisis; Intensive Care, Neonatal; Enteral Nutrition