{
    "abstract": "Because of provider variability in feeding guideline application, a quality improvement (QI) initiative was begun to better standardize feeding initiation and advancement for preterm infants. Our specific, measurable, achievable, relevant, and timely aims included decreasing the time to reach full feeds by 35% and reducing the duration of central lines by 30% over 12 months in infants born between 25 and 30 weeks' gestation or with birth weight between 600 and 1250\u2009g.\nRegistered dietitians tracked central line days, parenteral nutrition (PN), enteral nutrition, fortification, guideline adherence, anthropometrics, necrotizing enterocolitis (NEC) cases, and central line-associated bloodstream infections (CLABSIs). QI progress charts were reviewed monthly.\nMean central line days decreased from 7.3 to 5.8. Days of PN decreased from 6.7 to 5.1. The day of life that enteral feeds were started decreased from 1.1 to 0.5. The number of days between starting enteral feeds and adding fortification decreased from 3.4 to 2.3 days. Full enteral feeds were achieved on average 2 days earlier. Birth weight was regained at around 10.2 days of life before the guideline was implemented and at a mean of 9.6 days after the guideline. There was no increase in cases of CLABSI or diagnoses of NEC.\nAfter implementation of this feeding QI initiative at a level 4 neonatal intensive care unit, central line duration and PN use were decreased and infants reached full enteral feeds earlier without changes in cases of NEC, CLABSI, or time to regain birth weight.",
    "authors": [
        {
            "affiliation": "Department of Pediatrics, Division of Neonatology, University of Washington, Seattle, Washington, USA.",
            "firstname": "Eliza",
            "initials": "E",
            "lastname": "Lagerquist"
        },
        {
            "affiliation": "Department of Pediatrics, Division of Neonatology, University of Washington, Seattle, Washington, USA.\nDepartment of Pediatrics, Division of Neonatology, University of Minnesota, Minneapolis, Minnesota, USA.",
            "firstname": "Benjamin J S",
            "initials": "BJS",
            "lastname": "Al-Haddad"
        },
        {
            "affiliation": "Department of Pediatrics, Division of Neonatology, University of Washington, Seattle, Washington, USA.",
            "firstname": "Jill",
            "initials": "J",
            "lastname": "Irvine"
        },
        {
            "affiliation": "Department of Pediatrics, Division of Neonatology, University of Washington, Seattle, Washington, USA.",
            "firstname": "Lucy",
            "initials": "L",
            "lastname": "Muskthel"
        },
        {
            "affiliation": "Department of Pediatrics, Division of Neonatology, University of Washington, Seattle, Washington, USA.",
            "firstname": "Angel",
            "initials": "A",
            "lastname": "Rios"
        },
        {
            "affiliation": "Department of Pediatrics, Division of Neonatology, University of Washington, Seattle, Washington, USA.",
            "firstname": "Kirtikumar",
            "initials": "K",
            "lastname": "Upadhyay"
        }
    ],
    "conclusions": "After implementation of this feeding QI initiative at a level 4 neonatal intensive care unit, central line duration and PN use were decreased and infants reached full enteral feeds earlier without changes in cases of NEC, CLABSI, or time to regain birth weight.",
    "copyrights": "\u00a9 2023 American Society for Parenteral and Enteral Nutrition.",
    "doi": "10.1002/ncp.10992",
    "journal": "Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition",
    "keywords": [
        "enteral nutrition",
        "guidelines",
        "neonates",
        "newborn infant",
        "parenteral nutrition",
        "quality improvement"
    ],
    "methods": null,
    "publication_date": "2023-04-11",
    "pubmed_id": "37035908",
    "results": "Mean central line days decreased from 7.3 to 5.8. Days of PN decreased from 6.7 to 5.1. The day of life that enteral feeds were started decreased from 1.1 to 0.5. The number of days between starting enteral feeds and adding fortification decreased from 3.4 to 2.3 days. Full enteral feeds were achieved on average 2 days earlier. Birth weight was regained at around 10.2 days of life before the guideline was implemented and at a mean of 9.6 days after the guideline. There was no increase in cases of CLABSI or diagnoses of NEC.",
    "title": "Feeding volume advancement in preterm neonates: A level 4 neonatal intensive care unit quality improvement initiative.",
    "xml": "<Element 'PubmedArticle' at 0x788504273ba0>"
}