Improving extrauterine growth: evaluation of an optimized, standardized neonatal parenteral nutrition protocol

Abstract

Objective: Poor extrauterine growth in very low birth weight (VLBW) neonates is common and associated with worsened long-term outcomes. We aimed to decrease growth restriction, measured by the change in weight z-score from birth to 36 weeks post menstrual age, from - 1.13 (baseline) to < -1 within 12 months.

Study design: The Model for Improvement was used in the design and implementation of an optimized, standardized parenteral nutrition protocol. Three Plan-Do-Study-Act cycles were completed and a [Formula: see text] and S control chart was created for the primary outcome.

Result: Mean weight z-score change from birth to 36 weeks post menstrual age improved by 23% to - 0.87. Improvements in early weight gain and linear growth were seen as well.

Conclusion: Use of the Model for Improvement to implement an optimized, standardized parenteral nutrition protocol can help improve extrauterine growth among VLBW infants.