P D Graziano1, K A Tauber2, J Cummings2, E Graffunder3, M J Horgan2. 1. Nursing (Neonatology), Albany Medical Center, Albany, NY, USA. 2. Pediatrics (Neonatology), Children's Hospital at Albany Medical Center, Albany, NY, USA. 3. Epidemiology, Albany Medical Center, Albany, NY, USA.
Abstract
OBJECTIVE: To develop an evidence-based feeding bundle to safely decrease the rate of PNGR in VLBW infants. STUDY DESIGN: The bundle was developed and implemented in January 2010, followed by 3 years of monitoring bundle compliance and infant outcomes (days to first feed (FD), days to reach full feeds (FF), and birth-discharge growth trajectories (delta z-score)). RESULTS: Data were collected on 482 infants (119 pre-bundle). PNGR decreased from 35% to 19% (P<0.01) and weight delta z-score improved from -0.82 to -0.45 (P<0.001). Percentage of infants with head circumference (HC) below 10th percentile at discharge decreased from 21% to 9% (P<0.01) and HC delta z-score improved from -0.65 to -0.17 (P<0.001). FD and FF also decreased significantly. Rates of necrotizing enterocolitis, peak alkaline phosphatase and peak direct bilirubin levels all trended downward. CONCLUSIONS: An evidence-based, standardized feeding bundle was safe and effective in reducing the rate of PNGR and in improving head growth in VLBW infants.
OBJECTIVE: To develop an evidence-based feeding bundle to safely decrease the rate of PNGR in VLBW infants. STUDY DESIGN: The bundle was developed and implemented in January 2010, followed by 3 years of monitoring bundle compliance and infant outcomes (days to first feed (FD), days to reach full feeds (FF), and birth-discharge growth trajectories (delta z-score)). RESULTS: Data were collected on 482 infants (119 pre-bundle). PNGR decreased from 35% to 19% (P<0.01) and weight delta z-score improved from -0.82 to -0.45 (P<0.001). Percentage of infants with head circumference (HC) below 10th percentile at discharge decreased from 21% to 9% (P<0.01) and HC delta z-score improved from -0.65 to -0.17 (P<0.001). FD and FF also decreased significantly. Rates of necrotizing enterocolitis, peak alkaline phosphatase and peak direct bilirubin levels all trended downward. CONCLUSIONS: An evidence-based, standardized feeding bundle was safe and effective in reducing the rate of PNGR and in improving head growth in VLBW infants.
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