Safety and Parental Satisfaction With Early Discharge of Preterm Infants on Nasogastric Tube Feeding and Outpatient Clinic Follow-Up

Abstract

Aim: To evaluate our early discharge program of preterm infants with nasogastric tube feeding (NTF) and close outpatient clinic follow-up with regard to safety, parent satisfaction and parental stress level. Methods: 119 preterm infants were discharged on NTF from our tertiary care neonatal unit (median gestational age 31.0 weeks, median birthweight 1,650 g). Parental satisfaction was evaluated by a standardized questionnaire. For safety assessment growth until term equivalent age and re-hospitalizations within 2 months after discharge were evaluated. Results: Infants were discharged home at a median gestational age of 35.4 weeks after a median hospital stay of 22 days. Follow up was attained in 95 of 104 parent-infant dyads. The majority of parents (94%) reported that they had made the right decision in taking their infant home on NTF. At the time of discharge 86% of parents felt very well-prepared to perform NTF. 70% Of parents rated their stress level at home as low (≤2 out of 5). There were no NTF associated readmissions and no growth faltering until term equivalent age. Conclusion: Early discharge of preterm infants with NTF together with outpatient clinic follow-up is very well-accepted by parents and appears to be safe.

Home Nasogastric Tube Program for NICU Infants: A Seven Year Retrospective Outcome Analysis

“…[2][3][4] Home nasogastric (HNG) tube feeding programs have shown high parental satisfaction and increased familial bonding without deprivation of an authentic biological environment. 5 HNG programs were developed to assist infants in their feeding development outside of the hospital environment. Studies have shown the safety and utilization of HNG programs not only for pre-term infants, but also for medically complex infants as well.…”

“…Parental satisfaction with a HNG program is very high since many experienced lower stress levels, had better child and caregiver attachment, and were likely to recommend the program to other parents. 5,7 Families also have the ability to attempt oral feeding at home before making the decision to undergo a procedure which could result in an additional hospital stay. Avoidance of prolonged NICU admission and additional hospitalizations decreases the risk of iatrogenic harm and costs for families and hospital systems.…”

Redesigning care to support earlier discharge from a neonatal intensive care unit: a design thinking informed pilot

“…A small pilot early discharge programme demonstrated a reduction in length of stay of 10.6 days and cost savings of US$7674/patient 11. Beyond cost, early discharge programmes are also associated with high-satisfaction and preparedness, and positive quality indicators (eg, growth and readmissions) 12. Prior research highlights potential savings, but also recognises a need for strategies to monitor and mitigate health risks of earlier discharge 13…”

Enhanced recovery in children: how could we go further?

“…For example, safety and parental satisfaction with early discharge of preterm infants on nasogastric tube feeding and outpatient clinic follow-up was evaluated. 24 One hundred and nineteen preterm infants were discharged on nasogastric tube feeding from a tertiary care neonatal unit. Parental satisfaction was evaluated by a standardized questionnaire.…”