Improving extrauterine growth: evaluation of an optimized, standardized neonatal parenteral nutrition protocol.

OBJECTIVE

Poor extrauterine growth in very low birth weight (VLBW) neonates is common and associated with worsened long-term outcomes. We aimed to decrease growth restriction, measured by the change in weight z-score from birth to 36 weeks post menstrual age, from - 1.13 (baseline) to < -1 within 12 months.

STUDY

DESIGN

The Model for Improvement was used in the design and implementation of an optimized, standardized parenteral nutrition protocol. Three Plan-Do-Study-Act cycles were completed and a [Formula: see text] and S control chart was created for the primary outcome.

RESULT: Mean weight z-score change from birth to 36 weeks post menstrual age improved by 23% to - 0.87. Improvements in early weight gain and linear growth were seen as well.

CONCLUSION

Use of the Model for Improvement to implement an optimized, standardized parenteral nutrition protocol can help improve extrauterine growth among VLBW infants.