Date of Award

3-22-2024

Embargo Period

7-31-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD) in Health & Rehabilitation Science

Department

Health Sciences and Research

College

College of Health Professions

First Advisor

Kit N. Simpson

Second Advisor

Heather S. Bonilha

Third Advisor

Janina Wilmskoetter

Abstract

There is a dearth of evidence supporting the safety and efficacy of orally feeding infants who require noninvasive respiratory support (NIRS). This dissertation investigates clinical practices surrounding orally feeding infants on NIRS. Manuscript 1 systematically reviews parameters impacting study of this practice. Findings emphasize the dearth of objective data surrounding this practice, and that additional research must be conducted before safety and efficacy outcomes of this practice can be established. Manuscript 2 retrospectively uses electronic health record data to describe which infant populations are orally fed during NIRS use, amount of NIRS used during infant oral feeding, changes in practice over time, and predictors for oral feeding during NIRS use, length of stay, and time on NIRS. Findings support that practice is variable, that patient-level factors can predict which infants are more likely to be fed on NIRS, and that orally feeding during NIRS use can impact length of stay and time on NIRS. The third paper qualitatively investigates clinical practices specific to feeding expert assessment and intervention in this population. Missing data in clinical notes limit ability to interpret safety and quality measures of this practice, and we used themes from documentation to recommend documentation practices.

Rights

Copyright is held by the author. All rights reserved.

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Available for download on Thursday, July 31, 2025

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