Are Enterally Fed ICU Patients Meeting Clinical Practice Guidelines?

Abstract

The proportion of patients meeting clinical practice guidelines compares favorably to similar studies. In some cases, patients' clinical conditions or unit HOB angle protocol explained not meeting guidelines. However, there were cases where reasons for not meeting guidelines were unknown.

Jordanian nurses' knowledge and responsibility for enteral nutrition in the critically ill

“…The mean of back rest elevation in the three sectors was approximately 42° which is absolutely optimal, Miller et al () found that only 4·9% of patients met the recommendation of maintaining HOB at 45°. The discrepancy in nursing practice towards HOB elevation was referred to insufficiency of nursing knowledge about the relationship between HOB elevation and the risk for VAP (Miller et al , , Reignier et al , , Mueller et al , ).…”

“…HOB elevation is a widely accepted aspiration reduction method achieved through keeping backrest elevated at least 30-45 • (Stroud et al, 2003, Williams and Leslie, 2005, Bourgault et al, 2007, McClave et al, 2009, Albertos et al, 2011. The mean of back rest elevation in the three sectors was approximately 42 • which is absolutely optimal, Miller et al (2008) found that only 4·9% of patients met the recommendation of maintaining HOB at 45 • . The discrepancy in nursing practice towards HOB elevation was referred to insufficiency of nursing knowledge about the relationship between HOB elevation and the risk for VAP (Miller et al, 2008, Reignier et al, 2010, Mueller et al, 2011.…”

Jordanian Critical Care Nursesʼ Practices Regarding Enteral Nutrition

“…In this study, nurses reported that they placed patients at a semi-Fowler position. Grape et al (2005) and Miller et al (2009) objectively measured the angle of the backrest elevation and found that the majority of patients were kept at a backrest elevation less than 30 ° . However, because this study utilized a self-administered questionnaire in data collection, there is a possibility for bias in reporting clinical practice.…”

“…There is increased incidence of pulmonary aspiration ( Grape et al, 2005 ;Miller, Grossman, Hindley, MacGarvie, & Madill, 2009 ;Wip & Napolitano, 2009 ). Although radiological examination is the gold standard for assessing NGT placement ( Bourgault & Halm, 2009 ;William & Leslie, 2005 ;Yantis & Velander, 2011 ), the majority of nurses in the studies reviewed relied on the auscultation method to check the placement of the NGT.…”

An Enteral Nutrition Protocol to Improve Efficiency in Achieving Nutritional Goals

“…[1][2][3] • Actual delivery of 60% to 70% of enteral feeding goals within the first week of ICU admission is associated with a shortened length of stay, shorter duration of mechanical ventilation, and fewer infectious complications. 4 • Use of enteral feeding protocols in ICUs promotes earlier initiation of enteral feedings, increases the volumes of feed delivered, optimizes number of calories received, and results in shorter hospital stays and improved morbidity and mortality outcomes.…”