title: A Continuous Quality Improvement Project to Implement Infant-Driven Feeding as a Standard of Practice in the Newborn/Infant Intensive Care Unit.
abstract: OBJECTIVE
  To increase the number of neonates who were fed according to cues prior to discharge and potentially decrease length of stay.
  
  
  METHODS
  Continuous quality improvement.
  
  
  METHODS
  Eighty-five bed level IV neonatal intensive care unit.
  
  
  METHODS
  Surgical and nonsurgical neonates of all gestational ages. Neonates younger than 32 weeks gestation, who required intubation, continuous positive airway pressure (CPAP), high flow nasal cannula (HFNC), or did not have suck or gag reflexes were excluded as potential candidates for infant-driven feeding.
  
  
  METHODS
  The project was conducted over a 13-month period using the following methods: (a) baseline data collection, (b) designation of Infant Driven Feeding (IDF) Champions, (c) creation of a multidisciplinary team, (d) creation of electronic health record documentation, (e) initial staff education, (f) monthly team meetings, (g) reeducation throughout the duration of the project, and (h) patient-family education.
  
  
  RESULTS
  Baseline data were collected on 20 neonates with a mean gestational age of 36 0/7(th) weeks and a mean total length of stay (LOS) of 43 days. Postimplementation data were collected on 150 neonates with a mean gestational age of 36 1/7(th) weeks and a mean total LOS of 36.4 days. A potential decrease in the mean total LOS of stay by 6.63 days was achieved during this continuous quality improvement (CQI) project.
  
  
  CONCLUSIONS
  Neonates who are fed according to cues can become successful oral feeders and can be safely discharged home regardless of gestational age or diagnosis.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Chrupcala
authors.forename: Taryn M
authors.initials: TM
authors.lastname: Edwards
authors.forename: Diane L
authors.initials: DL
authors.lastname: Spatz
mesh_terms: D001942:Breast Feeding / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D015931:Intensive Care, Neonatal / Q000379:methods*; D007902:Length of Stay; D009035:Mothers / Q000193:education; D017283:Neonatal Nursing / Q000379:methods*; D010348:Patient Care Team / Q000458:organization & administration; D058996:Quality Improvement / Q000592:standards*
keywords: bottle feeding; breast feeding; cues; intensive care; neonatal nursing