Standardized Application of Feeding Evaluations Using SMART Tool
Wake Forest University Health Sciences
Summary
Premature and medically complex infants have delayed development of oral feeding skills, leading to prolonged hospitalization, costs, and family stress. There is no "gold standard" infant feeding skill assessment tool for bedside clinicians. The research team developed a novel feeding skill assessment, the SMART Tool, to monitor infant feeding skill development in the neonatal intensive care unit. This study aims to determine whether this tool improves clinical outcomes, including reduced hospital days and enhanced safety and quality of infant feedings.
Description
The current recommendation for preventing infant feeding problems is to provide cue-based feeding, which entails optimizing feeding based on infant cues, including behavioral and physiological signs of stress. These recommendations rely on appropriately recognizing infant feeding cues to inform care instead of applying time-based, volume-driven care irrespective of cues. Care providers vary widely in their subjective assessment of feeding skills, often because they lack standard education on feeding skill assessment and a "gold standard" tool to objectively measure infant oral feeding skill le…
Eligibility
- Age range
- Up to 1 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Infants born between August 1, 2025, and July 31, 2026, AND admitted to NICU Exclusion Criteria: * No oral feeding started by July 15, 2026
Interventions
- BehavioralSMART Tool
The intervention in this implementation study involves (1) integrating the SMART Tool into electronic health records (EPIC), (2) educating all NICU staff (about 850 nurses, lactation consultants, speech-language pathologists, and physicians), and (3) Quality improvement to reinforce learning.
Locations (14)
- Advocate Good Shepherd HospitalBarrington, Illinois
- Advocate Trinity HospitalChicago, Illinois
- Advocate Sherman HospitalElgin, Illinois
- Advocate Condell Medical CenterLibertyville, Illinois
- Advocate Christ Medical Center (Advocate Children's Hospital - Oak Lawn)Oak Lawn, Illinois
- Advocate Lutheran General Hospital (Advocate Children's Hospital - Park Ridge)Park Ridge, Illinois