Effectiveness of an Oral Feeding Educational Nurse Program on Feeding Performance in Preterm Neonates

Completed

Brief Summary: Poor oral motor development in preterm neonates is common. Feeding problems lead to longer hospital stay and higher hospital cost. Different interventions have shown their efficacy to accelerate transition and move faster to full oral feeding autonomy. Our study aimed to evaluate the impact of a 2-year education nurse program on feeding pattern and hospital stay of preterm neonates.

This is an interrupted time series study placed in Intensive Care and Neonatal unit of an university hospital located in Lyon, France. All preterm neonates are included in the study, from April 2013 to January 2016.

Recruitment & Eligibility

Inclusion Criteria

Preterm neonates of less than 34 weeks' of gestation
Preterm neonates not requiring surgery with endotracheal intubation
Preterm neonates hospitalized in the Neonatology and Neonatal Intensive Care Unit of an university hospital, Lyon.
Preterm neonates discharged from hospital during the study period from April 2013 to January 2016

Exclusion Criteria

Preterm neonates presenting delivery age above 34 weeks' of gestation
Preterm neonates whose parents have expressed their opposition to participate to the study

Arm && Interventions

Group	Intervention	Description
Preterm neonates	Educational oral feeding nurse program	All preterm neonates of less than 34 weeks' of gestation admitted to the Neonatology and Neonatal Intensive Care unit of an university hospital located in Lyon, France

Primary Outcome Measures

Name	Time	Method
Mean age per month of full oral feeding achievement	Monthly for 34 months	The age (real and corrected) of weaning of naso-gastric tube of preterm neonates taken out of hospitalization during the month will be computed by subtracting the date of weaning from the date of birth.

Secondary Outcome Measures

Name	Time	Method
Mean length of hospital stay per month	Monthly for 34 months
Nurses and childcare assistants' satisfaction concerning the educational session	34 months	The opinion of nurses and childcare assistants will be collected about the program contents, the organization and the results waited on their practices of care. The qualities of teaching will be assessed by a 5-point Likert scale.
Percent of preterm neonates presenting with feeding difficulty symptoms	Monthly for 34 months	Preterm neonates will be considered as presenting with feeding difficulty symptoms if they present : * no demonstration of hunger cues and/or, * Coughing,choking or vomiting during bottle or breast feeding and/or, * Feed intake exceeding 30 minutes and/or, * Excitement, discomfort or arching of the back during feedings and/or, * Gagging or falling asleep during feedings and/or, * Refusal to feed. The monthly rate of neonates presenting feeding difficulty symptoms will correspond to the total number of neonates presenting feeding difficulty symptoms divided by the number of neonates hospitalized during the month.
Morbidity and mortality per month	Monthly for 34 months	The rate of following neonatal pathologies will be studied : * Bronchopulmonary dysplasia, * Necrotizing enterocolitis, * Periventricular leukomalacia, * Intra-ventricular haemorrhage, * Premature retinopathy, * Hypoxic ischaemic encephalopathy.

Locations (1): Hôpital Femme-Mère-Enfant des Hospices Civils de Lyon
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Bron, Lyon, France

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