Evaluating the Precision of Clinical Assessments for Feeding Intolerance

Feeding intolerance is a common occurrence in preterm infants, yet there are no precise measures for clinically assessing this potentially serious manifestation. This article reports the results of a study designed to evaluate neonatal intensive care (NICU) nurses’ precision in abdominal and emesis assessments, considered the most objective, observable signs of feeding intolerance. Forty-six NICU nurses participated in the study by observing pictures of preterm infant abdomens and pictures of “staged” emesis. There was little agreement among the participants regarding the infant abdomen pictures or the amount of emesis observed in the pictures. There was no relationship between years of NICU experience nurses’ assessments. The ability of nurses to assess clinical signs of potentially serious complications in preterm infants is critically important. Standardized education and training as well as precise assessment tools are needed.