Improving Outcomes for Infants with Single Ventricle Physiology through Standardized Feeding during the Interstage
Congenital heart disease is identified as the most common birth defect with single ventricle physiology carrying the highest mortality. Staged surgical palliation is required for treatment, with mortality historically as high as 22% in the four- to six-month period from the first- to second-stage su...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Nursing Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2016/9505629 |
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| _version_ | 1832548088100683776 |
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| author | Cindy Weston S. Adil Husain Christopher L. Curzon Steve Neish Gemma T. Kennedy Krista Bonagurio Kevin Gosselin |
| author_facet | Cindy Weston S. Adil Husain Christopher L. Curzon Steve Neish Gemma T. Kennedy Krista Bonagurio Kevin Gosselin |
| author_sort | Cindy Weston |
| collection | DOAJ |
| description | Congenital heart disease is identified as the most common birth defect with single ventricle physiology carrying the highest mortality. Staged surgical palliation is required for treatment, with mortality historically as high as 22% in the four- to six-month period from the first- to second-stage surgical palliation, known as the interstage. A standardized postoperative feeding approach was implemented through an evidence-based protocol, parent engagement, and interprofessional team rounds. Five infants with single ventricle physiology preprotocol were compared with five infants who received the standardized feeding approach. Mann-Whitney U tests were conducted to evaluate the hypotheses that infants in the intervention condition would consume more calories and have a positive change in weight-to-age z-score (WAZ) and shorter length of stay (LOS) following the first and second surgeries compared to infants in the control condition. After the protocol, the change in WAZ during the interstage increased by virtually one standard deviation from 0.05 to 0.91. Median LOS dropped 32% after the first surgery and 43% after the second surgery. Since first- and second-stage palliative surgeries occur within the same year of life, this represents savings of $500,000 to $800,000 per year in a 10-infant model. The standardized feeding approach improved growth in single ventricle infants while concurrently lowering hospital costs. |
| format | Article |
| id | doaj-art-cfd96a0ba2f44453af321c9733032be8 |
| institution | Kabale University |
| issn | 2090-1429 2090-1437 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Nursing Research and Practice |
| spelling | doaj-art-cfd96a0ba2f44453af321c9733032be82025-02-03T06:42:19ZengWileyNursing Research and Practice2090-14292090-14372016-01-01201610.1155/2016/95056299505629Improving Outcomes for Infants with Single Ventricle Physiology through Standardized Feeding during the InterstageCindy Weston0S. Adil Husain1Christopher L. Curzon2Steve Neish3Gemma T. Kennedy4Krista Bonagurio5Kevin Gosselin6Texas A&M University Health Science Center, College of Nursing, Bryan-College Station, TX, USADepartment of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USADepartment of Pediatrics, University of Nebraska, Division of Pediatric Cardiology, Lincoln, NE, USADepartment of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USADepartment of Family and Community Health Systems, University of Texas Health Science Center at San Antonio, San Antonio, TX, USAUniversity Health System, San Antonio, TX, USATexas A&M University Health Science Center, College of Nursing, Bryan-College Station, TX, USACongenital heart disease is identified as the most common birth defect with single ventricle physiology carrying the highest mortality. Staged surgical palliation is required for treatment, with mortality historically as high as 22% in the four- to six-month period from the first- to second-stage surgical palliation, known as the interstage. A standardized postoperative feeding approach was implemented through an evidence-based protocol, parent engagement, and interprofessional team rounds. Five infants with single ventricle physiology preprotocol were compared with five infants who received the standardized feeding approach. Mann-Whitney U tests were conducted to evaluate the hypotheses that infants in the intervention condition would consume more calories and have a positive change in weight-to-age z-score (WAZ) and shorter length of stay (LOS) following the first and second surgeries compared to infants in the control condition. After the protocol, the change in WAZ during the interstage increased by virtually one standard deviation from 0.05 to 0.91. Median LOS dropped 32% after the first surgery and 43% after the second surgery. Since first- and second-stage palliative surgeries occur within the same year of life, this represents savings of $500,000 to $800,000 per year in a 10-infant model. The standardized feeding approach improved growth in single ventricle infants while concurrently lowering hospital costs.http://dx.doi.org/10.1155/2016/9505629 |
| spellingShingle | Cindy Weston S. Adil Husain Christopher L. Curzon Steve Neish Gemma T. Kennedy Krista Bonagurio Kevin Gosselin Improving Outcomes for Infants with Single Ventricle Physiology through Standardized Feeding during the Interstage Nursing Research and Practice |
| title | Improving Outcomes for Infants with Single Ventricle Physiology through Standardized Feeding during the Interstage |
| title_full | Improving Outcomes for Infants with Single Ventricle Physiology through Standardized Feeding during the Interstage |
| title_fullStr | Improving Outcomes for Infants with Single Ventricle Physiology through Standardized Feeding during the Interstage |
| title_full_unstemmed | Improving Outcomes for Infants with Single Ventricle Physiology through Standardized Feeding during the Interstage |
| title_short | Improving Outcomes for Infants with Single Ventricle Physiology through Standardized Feeding during the Interstage |
| title_sort | improving outcomes for infants with single ventricle physiology through standardized feeding during the interstage |
| url | http://dx.doi.org/10.1155/2016/9505629 |
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