Implementation of Cue-Based Feeding to Improve Preterm Infant Feeding Outcomes and Promote Parents' Involvement.

Abstract Objective To implement cue-based feeding for preterm infants and to assess its effects on time to achieve full oral feedings, length of stay, and parents’ involvement in the feeding process. Design A quality improvement project with a pre–post evidence-based practice implementation design. Setting Level III NICU in a quaternary hospital in the U.S. Northeast. Patients Medical records of preterm infants from 23 0/7 weeks to 31 6/7 weeks gestational age who were eligible for initiation of oral feeding. Intervention/Measurements We implemented cue-based feeding through staff education and training. We completed a retrospective review of the medical records of 82 preterm infants before implementation and 167 preterm infants after implementation for the outcomes of time to achieve full oral feedings, length of stay, and parents’ involvement in the feeding process. Results For infants 23 0/7 weeks to 27 6/7 weeks gestation, time to achieve full oral feedings decreased by 7 days, length of stay decreased by 4.4 days, and parents’ involvement in the feeding process increased by 80% from before to after implementation. For infants 28 0/7 weeks to 31 6/7 weeks, time to achieve full oral feedings decreased by 6.6 days, length of stay decreased by 2.7 days, and parents’ involvement in the feeding process increased by 49% from before to after implementation. The organization saved $103,950 per year by decreasing length of stay. Conclusions Cue-based feeding decreased time to achieve full oral feedings, decreased length of stay, increased parents’ involvement in the feeding process, and resulted in cost savings for the institution.