Abstract
The purpose of this project was to establish an Infant Driven Feeding (IDF) protocol for preterm and late preterm infants to facilitate the time to full oral feeds and reduce length of stay. In the Neonatal Intensive Care Unit (NICU), achievement of full oral feedings and weight gain are milestone achievements needed for discharge. Feeding difficulties may lengthen time to discharge and make these milestones more difficult to attain. IDF uses a standardized protocol for preterm and late preterm infants to provide a consistent and developmentally appropriate approach to initiation of oral feedings, and the progression of feeds.|The setting was AdventHealth Tampa’s Neonatal Intensive Care Unit (NICU) Included were preterm infants who were 32 -36 weeks gestation and included 58 infant’s pre-implementation and 18 infant’s post-implementation. The Rosswurm and Larrabee theoretical framework was used for this project to guide the methods utilized to implement a practice change. The design of the project was a retrospective chart review and Vermont Oxford Network (VON) data review, as well as, a prospective chart review and VON data review.|Results: Time to initiation of oral feedings was improved post-implementation in 34 and 35-week infants. Time to full oral feedings were decreased by 4.25 days in 32-week infants, 5.44 days in 33 weeks infants, 5.38 days in 34-week infants, 3.64 days in 35-week infants, and 0.16 days in 36-week infants. Time to discharge was improved in 36-week infants by 0.83 days, 35 weeks decreased by 2.86 days, 34 weeks decreased by 4.5 days, 33 weeks decreased by 8.89 days, and 32 weeks decreased by 0.75 days. The IDF approach was associated with a significant reduction in time to achieve full oral feeds, and time to discharge in all gestational ages. The benefits of using an IDF protocol will help to ensure positive outcomes in feeding neonates as well as lowering the length of stay in the NICU.