Prevalence and Impact of Feeding-Related Events on Hospital Stay in Preterm and Term Newborns.

BACKGROUND: Nursing assessment of milk flow regulation and associated apnea, bradycardia, and desaturation (ABD events) contribute to considerations for the discharge of newborns from the acute care setting. Research regarding infant feeding-related (FR) events (sucking and swallowing difficulties) and ABD events in moderate to late-preterm and full-term infants is lacking. PURPOSE: This study observes the impact of FR and ABD events during feeding on hospital length of stay (LOS) and healthcare utilization (cost) in moderate-to-late preterm newborns, as well as full-term infants. METHODS: In a retrospective study, bottle-fed infants admitted to the level II specialty care nursery of an academic community hospital in Southern California were observed for FR and ABD events. Statistical analyses were used to determine the impact of FR events on adjusted LOS, to evaluate the interaction between FR event status and adjusted LOS on total hospital charges, and to assess the statistical independence between FR events and diagnostic-related group severity. RESULTS: The full sample of patient records included 308 infants born between 32- and 44-week gestational age between April 1, 2018, and October 31, 2022. LOS was twice as long in infants who had FR events. Total median charges were higher in the group with FR events at $160,165 versus $64,380 with non-FR events. IMPLICATIONS FOR PRACTICE AND RESEARCH: Increased knowledge in the epidemiology and nursing care of infants experiencing milk flow regulation and associated ABD events is critical for informing practices and guidelines related to the prevention of related morbidities.

Mentoring Clinical Nurses Toward a Just Culture: Successful Implementation of Nursing Peer Case Review.

The nursing peer-review process is an effective and underutilized method to enhance nurse accountability and ownership of patient care and nursing practice. This article describes how 1 hospital created a clinical nurse-driven, nonpunitive, peer case review structure and mentorship processes. This innovative structure provides a framework to support nurses through shared governance and supports organizational efforts including Magnet® and Just Culture initiatives.