The Effects of Implementing the Clinical Nursing Practice Guideline Concerning Oral Feeding Stimulation of Infants Weighed Less than 2,000 Grams in Sick Newborn Ward, Nan Hospital

Abstract

The objective of this quasi-experimental research was to examine the effects of implementing a clinical nursing practice guideline for oral feeding stimulation of infants with birth weight less than 2,000 grams. This study compared 3 factors during the transition period from tube feeding to oral feeding: number of days when oral feeding≥ half of the total milk supply, number of days in oral feeding, and number of days in retaining feeding tubes. Purposive sampling was employed. 36 infants diagnosed with feeding problem admitted to the hospital between July 2018 and June 2019 were assigned to the control group. 26 infants diagnosed with feeding problem admitted to the hospital between July 2019 and June 2020 were assigned to the experimental group. The experimental group received oral stimulation following the clinical nursing practice guideline. Occupational therapists and nurses gave oral stimulation about 5 minutes, around 15-30 minutes before feeding. The procedure was employed twice a day in the morning and evening, 6 hours apart. The control group received normal care routine. The Mann-Whitney-Wilcoxon (Rank Sum Test) was used to compare the outcomes between the experimental group and the control group.

The results showed that after applying this clinical nursing practice guideline in the experimental group, the mean rank of the number of days when oral feeding≥  half of the total milk supply decreased significantly from 36.4 to 24.71 days (p-value = 0.011). The number of days in oral feeding also dropped dramatically from 37.93 to 22.60 days (p-value = 0.001), and the number of days in retaining feeding tubes reduced significantly from 36.51 to 24.56 days (p-value< 0.05). These findings suggests that health care centers can apply this clinical nursing practice guideline in order to improve the quality of care in infants swallowing difficulty by reducing the duration of retaining feeding tube,  increasing the duration of full oral feeding, and decreasing length of stay in hospitals.