Article Text
Abstract
Background Discharge guidelines for premature infants at Canberra Hospital were changed in 2005, and allowed parents to administer gavage feeds at home with provision of in-home support with the aim to promote early discharge, and to facilitate positive patient and family centred outcomes without jeopardising patient care. The aim of this study was to evaluate the effects this practice compared to standard practice of maintaining inpatient status until suck feeds were established.
Methods Retrospective cohort study of all premature infants admitted to the NICU between 2004 and 2007. The study group (34 infants) was discharged with nasal gastric tube in-situ and parents administering feeds in the home environment. The control group (34 infants) was discharged when all but 2 feeds were suck feeds. A nurse visited the family home to administer the remaining feeds. Data was prospectively collected for short-term outcomes.
Results No increased risks of complications were seen between the groups. Study group infants were slightly younger compared to controls but spent the same amount of time as inpatients. The program effectively decreased the amount of time spent as an inpatient. No differences were seen when comparing rate of weight gain, discharge weights, or gestational age at nasogastric tube removal.
Conclusions This program has shown that early discharge with parental nasogastric tube feeding is not harmful to the infant. This has potential to increase family centered care for the infant and decrease costs by minimizing the necessity for inpatient care.