The Milk Technician Program at Naval Medical Center Portsmouth (NMCP) was awarded the Vikki Garner Award for Excellence in Quality Improvement March 17.

The Neonatal Intensive Care Unit introduced this evidence-based, quality-improvement project about two years ago. The program has been successful in improving clinical outcomes for these fragile infants.

Since the program was implemented, it has led to decreased time for infants to reach full feeds, which means infants are able to discontinue IV fluid and remove central lines sooner.

"The average length of time to reach a full feed has decreased by 2.2 days," said Valerie Hoehn, NICU dietician.

The Milk Technician Program offers benefits to both infants and nurses in the NICU. Before the program was started, nurses were responsible for preparing feedings for their assigned infants.

"This meant that each nurse was away from the bedside for an average of 1.2 hours per each 12 hour shift," Hoehn said.

Implementation of the program has allowed nurses to practice to the full extent of their scope, by removing a time-consuming task that has proven be more appropriately suited for a technician. Having feedings prepared in a standardized manner by one small team reduces risk for infection by contamination and errors in feeding preparation.

Improving on the process already in place, a small team of hospital corpsmen were selected to become technicians. Following four weeks of training, technicians now serve the NICU, preparing and verifying the milk and sometimes feeding the infants as well.

"The technicians were trained in the proper handling, storage, fortification and preparation of human milk and formula for infants," Hoehn said.

The technicians are required to pass a written and practical examination demonstrating understanding and proficiency in the role.

"Each infant's feeding order is unique and requires measuring a certain amount of breast milk or formula and, if necessary, adding a specific amount of fortifier to reach that desired caloric density and nutrient content," said Lt. LaTarya Smith, NICU division officer.

The goal, according to Smith, was to minimize the risk of contamination and variability between individuals who prepared milk.

"At NMCP, the Milk Technician Program met the demand for a safe and standardized way to prepare enteral feedings," Smith said.

Feedings can be done through syringes, tubes or bottles. The goal of each feeding is to ensure the babies are reaching a full feed.

"A full feed is how much the baby should take to meet their caloric requirements to grow appropriately," said Hospitalman Chandra Pleasant. "If they should be feeding 24 milliliters and feed that amount - then it is a full feed."

According to Pleasant, one of the best things about being a technician is watching the babies become healthier and knowing she has a direct impact.

"I help them get the necessary weight calories they need to go home," Pleasant said. "If the baby is not gaining enough weight, I provide the proper nourishment for them to be able to heal and grow and go home."

Continued improvement of this intervention focuses on improving milk technician education and training, establishing communication strategies, improving nursing involvement, and ensuring adequate support and supplies are available to milk technicians.

The Vikki Garner Memorial Award for Excellence in Quality Improvement is awarded annually to an individual or a team that identifies a significant quality improvement opportunity and implements an innovative solution which improves the quality of care. The award recognizes achievements that will have a long-lasting impact on reaching the goal of improving the quality of care and promoting a culture of patient safety throughout the command.

For more news from Naval Medical Center Portsmouth, visit www.navy.mil/.