New policy at Texas Health Dallas helps caregivers, parents
Parents of premature infants or other babies who need special care spend days, weeks, months at the hospital with their tiny ones, learning how and when to feed them, hoping they’ll start to use a bottle or the breast, waiting for the day when they finally can take them home.
Thanks to nurse Leslie Scott, B.S.N., supervisor of the special care nursery at Texas Health Presbyterian Hospital Dallas, and the hospital’s Feeding/Nutrition Committee, the complex instructions are consistent and parents will soon have a brochure filled with tips on cue-based feeding to use once babies are discharged.
Cue-based feeding, also known as infant-driven feeding, has been used at the hospital for eight or nine years. Nurses were initially trained on the method and over time the instructions were passed down from nurse to nurse. Scott saw an opportunity to create a written, step-by-step Texas Health Dallas policy for the special care nursery and in the neonatal intensive care unit
The brochure for parents was an outgrowth of the policy. Premature babies or others who need special care have to learn to balance their food intake with their energy expenditure, even after they go home.
Committee hits ground running
“We came up with the idea of developing a committee,” she said. The multidisciplinary committee, started in 2018, included a neonatologist on the medical staff of the hospital, dietitian, occupational therapist, lactation nurse and nurse educator as well as bedside nurses from the NICU and special care nursery. They hit the ground running, said Leslie, chairperson of the committee.
The committee gathered information, including consulting the Texas Health Resources system to look at ways other hospitals had succeeded with a policy.
The result was a comprehensive 13-page document that covers every detail, including policy on cue-based breastfeeding for premature babies.
Help for parents
“The next thing we identified was that we needed a way to help our parents understand,” Leslie said. “We put together a parent brochure in English and Spanish.”
The plan is to use the brochure systemwide, she said. It describes each type of caregiver involved in the family and baby’s care and includes steps for positive bottle feeding and breastfeeding. A message “From Your Baby’s Doctor” also is included.
Melissa Reyna, M.P.H., R.N., ICCE, coordinator of patient education in Integrated Experience, said the brochure is available to order for systemwide use now.
“Babies who spend time in the NICU and special care nursery typically have a different feeding experience than other babies,” Melissa said. “A baby has to learn to suckle and balance their food intake and their energy expenditure. Helping families understand that this will take some time helps allay natural concerns.”
Melissa worked with the committee to produce the brochure. She said she works with publications to help patients and families better understand their health care.
With clear information, “families can better understand how to make better health choices and be better advocates for their newborns.” she said.
‘Incredible’ teamwork
Both the policy and the brochure were “an incredible demonstration of teamwork and diligence,” said Suzanne Murphy, M.S.N., R.N., NE-BC, nursing, women’s and infants director at Texas Health Dallas.
“This group brought many disciplines together to work on an initiative that was near and dear to their hearts over an extended period of time. The impact from these humble beginnings is now spread across the system. It’s a great example of sharing evidence-based practice to improve the health of the communities we serve.”
( Pictured: Nurse Leslie Scott, B.S.N., was a key force behind the new cue-based feeding policy at Texas Health Dallas.)
By Judy Wiley • Posted July 30, 2019
