title: An evidence-based approach to nipple feeding in a level III NICU: nurse autonomy, developmental care, and teamwork.
abstract: Historically, nipple feeding in the NICU has been initiated and advanced by physician order based on nursing observation and suggestions. The growing evidence base regarding nipple feeding readiness and progression, contingent caregiving, and nurse autonomy in decision making prompted our Level III NICU to reconsider our process. A literature review and discussions resulted in new protocols for initiating and advancing nipple feedings for three distinct groups: healthy preterm infants, preterm infants with complicated medical courses, and sick term or posttcrm infants. Through incorporating contingent earegiving, greater autonomy for the bedside nurse, developmental support, and collaboration, we expect to improve outcomes, comnuinication, and problem solving.
authors.affiliation: Wheaton Franciscan Healthcare-St. Joseph, Milwaukee, WI 53210, USA. catherine.shaker@wfhc.org
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Shaker
authors.forename: Amy Marie Werner
authors.initials: AM
authors.lastname: Woida
mesh_terms: D000465:Algorithms; D001903:Bottle Feeding / Q000451:nursing*; D001942:Breast Feeding; D015400:Clinical Nursing Research; D002985:Clinical Protocols; D003142:Communication; D003299:Cooperative Behavior; D003663:Decision Trees; D019317:Evidence-Based Medicine; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007235:Infant, Premature, Diseases / Q000451:nursing; D015931:Intensive Care, Neonatal / Q000379:methods; D007400:Interprofessional Relations; D017283:Neonatal Nursing / Q000458:organization & administration*; D024802:Nurse's Role; D009730:Nursing Assessment / Q000379:methods*; D010351:Patient Discharge; D018579:Patient Selection; D011340:Problem Solving; D017009:Professional Autonomy; D013391:Sucking Behavior