208 - Implementing Food Insecurity Screening in the NICU at Maynard Children’s Hospital

Poster Number: 208
Publication Number: 208.126

Kevin Travia, Brody School of Medicine, Farmville, NC, United States; John A. Kohler, Brody School of Medicine at East Carolina University, Greenville, NC, United States; Uduak Akpan, Brody School of Medicine at East Carolina University, Greenville, NC, United States

Background: Food insecurity (FI) defined as the lack of sufficient food for an active, healthy life, is a nationwide concern and may negatively affect children’s health outcomes.  Up to 66% of children in the area served by our institution receive free or reduced cost lunches, underscoring the need for identification of FI as soon as possible. This QI project aims to address the lack of a standardized screening process for FI at the Maynard Children’s Hospital (MCH) NICU.

Objective: To achieve 95% screening for FI amongst the families of neonates admitted to the Maynard Children’s Hospital (MCH) NICU within 6 months.

Design/Methods: A team was formed comprising a neonatologist, NICU social workers, medical student, nursing staff, and IT personnel. A 2-question FI screening tool, recommended by the American Academy of Pediatrics (AAP), was implemented, to be administered during the social worker intake interview at admission. The following are the two questions identified for FI: We worried whether our food would run out before we got money to buy more; The food we bought just didn’t last, and we didn’t have money to get more. If a family responded yes to either question, they were considered to be food insecure and resources such as WIC, SNAP, and local food banks were provided. For the first PDSA cycle, a dot phrase was added to the NICU social work EPIC EHR note template. The second PDSA cycle involved training cross-covering social workers to use the NICU dot phrase and note template to ensure continuity in the process. The number of families that reported FI was low and so, the third PDSA cycle involved informing families about the reasons for the FI Screening questions and assuring them that there were no consequences for reporting FI. Data collection and analysis were performed monthly. The outcome measure for this project was the percentage of families reporting FI and the process measure was the percentage of NICU families screened for FI.

Results: This project is ongoing. So far, data collection has been completed for 5 months and the percent screened is 95.1% with a standard deviation of 5.08. Goal screening rate of 95% has been met. Overall, 8.7% of families screened report FI and these have been connected to appropriate resources. The third PDSA that aims to make patient families feel more comfortable discussing this sensitive issue is still in progress.Conclusion(s): FI negatively impacts health outcomes and can lead to increased hospitalizations from birth. Implementing a reproducible, 2-question, FI questionnaire at the MCH NICU has early screening and identification of FI.
CV 1-5-22.pdf
Maynard Children's Hospital NICU Positive for FIGraph 2 shows the number of families who screened positive for FI at the MCH NICU. Each week is defined as starting on Sunday and ending on Saturday.