Journal of perinatology : official journal of the California Perinatal Association · 2026
Improving preoperative enteral feeding for newborns with congenital heart disease.
СтатьяНазвание и аннотация: Перевод в очереди
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Brandfonbrener Paul B, Gorsky Katharine G, Marks Catherine, Hetherton Maria, Kramer Katelin P, Steurer Martina A
Аннотация
OBJECTIVE: The aim of this quality improvement project was to increase preoperative enteral feeding and breastfeeding rates in term neonates with congenital heart disease (CHD).
METHODS: A multidisciplinary team developed and implemented a preoperative feeding protocol for neonates with congenital heart disease. The primary outcome was the presence of preoperative enteral feeding by May 2025. Secondary outcomes included breastfeeding rates and time to first feed. The process measure was the rate of reference to the feeding protocol in provider notes. Our balancing measure was a rule out or diagnosis of necrotizing enterocolitis requiring medical or surgical treatment in the preoperative period. Infants were identified using the Pediatric Cardiac Critical Care Collaborative (PC4). Data was collected from chart review and analyzed with statistical process control charts. The pre-implementation period was from June 2022 to June 2023, the implementation period was from July 2023 to June 2024, and the sustainment period was from July 2024 through May 2025.
RESULTS: The number of neonates that met the inclusion criteria was 121. The rate of overall enteral feeding increased significantly from 72% in the pre-implementation phase (June 2022-June 2023) to 93% in the sustainment phase (July 2024-May 2025) (p = 0.026). Additionally, we found an improvement in our secondary outcomes and no change to the balancing measures.
CONCLUSION: This quality improvement initiative, which centered on creating and implementing a clear, standardized, evidence-based feeding protocol while utilizing interdisciplinary collaboration, led to an increase in overall rates of preoperative enteral feeding for newborns with CHD in a level IV intensive care nursery.
METHODS: A multidisciplinary team developed and implemented a preoperative feeding protocol for neonates with congenital heart disease. The primary outcome was the presence of preoperative enteral feeding by May 2025. Secondary outcomes included breastfeeding rates and time to first feed. The process measure was the rate of reference to the feeding protocol in provider notes. Our balancing measure was a rule out or diagnosis of necrotizing enterocolitis requiring medical or surgical treatment in the preoperative period. Infants were identified using the Pediatric Cardiac Critical Care Collaborative (PC4). Data was collected from chart review and analyzed with statistical process control charts. The pre-implementation period was from June 2022 to June 2023, the implementation period was from July 2023 to June 2024, and the sustainment period was from July 2024 through May 2025.
RESULTS: The number of neonates that met the inclusion criteria was 121. The rate of overall enteral feeding increased significantly from 72% in the pre-implementation phase (June 2022-June 2023) to 93% in the sustainment phase (July 2024-May 2025) (p = 0.026). Additionally, we found an improvement in our secondary outcomes and no change to the balancing measures.
CONCLUSION: This quality improvement initiative, which centered on creating and implementing a clear, standardized, evidence-based feeding protocol while utilizing interdisciplinary collaboration, led to an increase in overall rates of preoperative enteral feeding for newborns with CHD in a level IV intensive care nursery.