Why do NICU nurses not refeed gastric residuals prior to feeding by gavage?

The purpose of this study was to determine why NICU nurses do not refeed gastric residuals to preterm infants prior to feeding by gavage. To gather the data, we delivered questionnaires to all 75 NICU registered nurses at a southeastern regional hospital. The nurses were told the study was to learn "about nursing practice in relation to gavage feedings." Thirty-five percent (26) of the questionnaires were completed and returned within the two-week data collection period. Although the literature recommends refeeding gastric aspirates to premature infants prior to gavage feedings, only two (8 percent) of the respondents indicated that they do this at least half the time. Many (54 percent) indicated that they knew refeeding residuals benefited preterm infants. However, more than half (58 percent) selected "doctors in this hospital do not order" as their rationale for not refeeding. More studies with larger sample sizes need to be done to assess accurately the reasons that nurses do not refeed gastric residuals. The findings of this study suggest (1) inservice educational programs should be developed regarding the value of refeeding residuals and (2) nurses' awareness of their decision-making ability should be increased.