Date of Conferral



Doctor of Nursing Practice (DNP)




Murielle Beene


Developmental delays related to feeding dysfunction in premature infants can lead to lengthy hospitalizations and increased healthcare costs initially and throughout the first year of the child's life. The purpose of this project was to use readiness-to-feed assessments to evaluate the impact of an infant-driven feeding protocol on length of stay. The project compared the length of stay of 2 groups of infants: a demand fed according to a readiness-to-feed protocol (protocol group, n = 14) and a traditionally fed according to scheduled, volume-driven feedings (traditional group, n = 15). The logic model served as the change management framework and synactive theory of infant development provided the theoretical framework. According to Als' synactive theory, a shortened hospital stay for premature infants may reduce adverse effects related to neurosensory development, delayed bonding, and a distant parenting experience. A quantitative research design was used, and data were collected through a retrospective chart review of the 2 groups. Descriptive statistics and analysis of variance were completed. The findings indicated that the length of stay in the protocol group was less than the length of stay in the traditionally fed group and that the difference was statistically significant (p = 0.03). Social change benefits related to the project include improved family bonding, improved neurosensory development of infants, and a reduction in healthcare costs as a result of a shortened length of stay. The findings of this project demonstrated that by using the readiness-to-feed protocol, neonatal intensive care nurses can decrease lengths of stay and costs of hospitalization while reducing adverse effects of traditional care on infant development and bonding.