Background

Extrauterine growth restriction from inadequate nutrition remains a significant morbidity in very low birth weight infants. Participants in the California Perinatal Quality Care Collaborative Quality Improvement Collaborative, Grow, Babies, Grow! developed or refined tools to improve nutrition and reduce practice variation.

Method

Five Neonatal Intensive Care Units describe the development and implementation of nutrition tools. Tools include Parenteral Nutrition Guidelines, Automated Feeding Protocol, electronic medical record Order Set, Nutrition Time-Out Rounding Tool, and a Discharge Nutrition Recommendations. 15 of 22 participant sites completed a survey regarding tool value and implementation.

Results

Reduced growth failure at discharge was observed in four of five NICUs, 11–32% improvement. Tools assisted with earlier TPN initiation (8 h) and reaching full feeds (2–5 days). TPN support decreased by 5 days. 80% of survey respondents rated the tools as valuable.

Conclusion

Evidence and consensus-based nutrition tools help promote standardization, leading to improved and sustainable outcomes.

中文翻译：

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用于提高护理和新生儿营养一致性的多学科循证工具

背景

营养不足导致的宫外生长受限仍然是极低出生体重婴儿的一个重要发病率。加州围产期质量护理协作质量改进参与者 协作，成长，婴儿，成长！开发或完善工具以改善营养并减少实践差异。

方法

五个新生儿重症监护室描述了营养工具的开发和实施。工具包括肠外营养指南、自动喂养方案、电子病历订单集、营养超时舍入工具和出院营养建议。 22 个参与站点中的 15 个完成了有关工具价值和实施的调查。

结果

在 5 个 NICU 中的 4 个中观察到出院时生长障碍减少，改善了 11-32%。工具有助于更早开始 TPN（8 小时）并达到全喂食（2-5 天）。 TPN 支持减少了 5 天。 80% 的受访者认为这些工具很有价值。

结论

基于证据和共识的营养工具有助于促进标准化，从而改善和可持续的结果。