Neonatal Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.
Université Lyon I, Villeurbanne, France.
Nurs Crit Care. 2024 Mar;29(2):287-295. doi: 10.1111/nicc.12840. Epub 2022 Aug 31.
Premature neonates often experience feeding difficulties during their hospital stay, and evidence-based interventions have been shown to improve feeding outcomes.
This study investigated whether an infant-cue based nurse educational feeding bundle accelerates the achievement of independent oral feeding in neonates in a neonatal intensive care unit.
A quality improvement study with a pre, during and post intervention test design. All premature neonates admitted to the unit were eligible. The feeding programme included a four-month nurse training module and nurse coaching.
A hundred and twenty-five nurses or nurse assistants attended the programme and 706 neonates were included. The median time to independent oral feeding (IOF) was 40, 36 and 37 days, respectively, for pre, during and post intervention. The reduction in time to IOF observed during the post-intervention period compared with the baseline period was significant (HR = 1.32, CI 95%: 1.01-1.74). No difference was noted in the length of hospital stay between the three study periods.
An infant-cue based nurse educational feeding bundle can promote earlier achievement of IOF in preterm neonates.
This quality improvement study demonstrates the impact that a nurse-driven intervention in neonatal care can have on improving practice. Feeding interventions involve the early introduction of oral feeding, non-nutritive sucking (NNS), and oral motor stimulation, and should be individualized for each neonate. These individualized feeding interventions applied by all nurses and assistant nurses, can facilitate the achievement of earlier independent oral feeding in preterm infants and should be included in neonatal critical care nurse education programs.
早产儿在住院期间经常会出现喂养困难的情况，有证据表明，基于婴儿线索的干预措施可以改善喂养结局。
本研究旨在探讨基于婴儿线索的护士教育性喂养方案是否能加速新生儿重症监护病房中早产儿实现自主口腔喂养。
这是一项质量改进研究，采用了预干预、干预期间和干预后测试设计。所有入住该单元的早产儿都有资格参加。喂养方案包括为期四个月的护士培训模块和护士指导。
125 名护士或护士助理参加了该项目，共有 706 名早产儿入组。独立口腔喂养（IOF）的中位时间分别为干预前、干预期间和干预后 40、36 和 37 天。与基线期相比，干预后期间观察到的 IOF 时间缩短具有显著意义（HR=1.32，95%CI：1.01-1.74）。三个研究期间的住院时间无差异。
基于婴儿线索的护士教育性喂养方案可促进早产儿更早实现 IOF。
这项质量改进研究表明，新生儿护理中以护士为驱动的干预可以对改善实践产生影响。喂养干预包括早期引入口腔喂养、非营养性吸吮（NNS）和口腔运动刺激，并应根据每个早产儿的情况进行个体化。这些由所有护士和助理护士应用的个体化喂养干预措施，可以促进早产儿更早实现自主口腔喂养，应纳入新生儿重症监护护士教育项目中。
