Date of Graduation

Spring 5-18-2023

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Family Nurse Practitioner

First Advisor

Jo Loomis

Second Advisor

Nancy Selix

Third Advisor

Dena Cuyjet


Neonatal feeding practices have been the focus of many quality improvement studies due to large variations in care practices. Traditionally, the model for neonatal feeding has been a volume-based approach, one that focuses on a prescribed quantity consumed rather than the infant’s physiologic and developmental maturity (Fry et al., 2018). Recent literature has emphasized the benefits of a more developmentally supportive feeding approach in neonatal intensive care units (NICU), the infant-driven feeding model (IDF).

The IDF model focuses on individualized care, quality of the feed, and continuous assessment of feeding cues both before and during the feeding experience. Current literature has associated the infant-driven approach with numerous positive outcomes including shorter time to attainment of oral feedings, increased velocity of weight gain, shorter length of stay, increased caregiver satisfaction, and lower cost to the family and organization (Fry et al., 2018). This Doctor of Nursing Practice (DNP) quality improvement project herein details an evidence-based educational intervention to assist in transitioning clinical staff from a volume-based to an IDF approach. This intervention draws on the PRECEDE-PROCEED framework and Theory of Reasoned Action/Planned Behavior conceptual models for support. The Outcomes were measured via pre-and post-intervention surveys to measure the effectiveness of the educational intervention on staff attitudes, knowledge, and skills. In general, the pre- and post-intervention survey results were comparable demonstrating a <0.75 point deviation between intervals, however analysis and conclusions are limited due to a small sample size.