Improvement of enteral nutrition in intensive care unit patients by a nurse‐driven feeding protocol

Friesecke, Sigrun; Schwabe, Anna; Stecher, Stephanie-Susanne; Abel, Peter

doi:10.1111/nicc.12067

Cited by 38 publications

(33 citation statements)

References 41 publications

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“…Such protocolized care may also create a standard unit-based practice that bedside professionals (e.g., nurse or respiratory therapist) implement or override as needed. These have been used in the prevention of device-related infections [25–34] and nutrition management [35–37]. …”

Section: Recently Examined Use Of Defaults In Critical Care Medicinementioning

confidence: 99%

Default options in the ICU

Hart

Halpern

2014

Current Opinion in Critical Care

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Purpose of review Default options dramatically influence the behavior of decision makers and may serve as effective decision support tools in the ICU. Their use in medicine has increased in an effort to improve efficiency, reduce errors, and harness the potential of healthcare technology. Recent findings Defaults often fall short of their predicted influence when employed in critical care settings as quality improvement interventions. Investigations reporting the use of defaults are often limited by variations in the relative effect across sites. Preimplementation experiments and long-term monitoring studies are lacking. Summary Defaults in the ICU may help or harm patients and clinical efficiency depending on their format and use. When constructing and encountering defaults, providers should be aware of their powerful and complex influences on decision making. Additional evaluations of the appropriate creation of healthcare defaults and their resulting intended and unintended consequences are needed.

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Section: Recently Examined Use Of Defaults In Critical Care Medicinementioning

confidence: 99%

Default options in the ICU

Hart

Halpern

2014

Current Opinion in Critical Care

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“…These protocols can greatly improve nutrition outcomes and work efficiency . In an acute setting these protocols also empower nursing staff to independently initiate and escalate EN support, and assist with troubleshooting . One study evaluating a transition feeding protocol (TFP) in the critical care setting concluded that the use of a TFP from parenteral nutrition (PN) to EN increased the proportion of patients meeting nutritional adequacy; while another in the same setting reported improved patient nutrition status and nurses’ awareness on nutrition support for a protocol from PN to EN/ON .…”

Section: Introductionmentioning

confidence: 99%

Improving nutrition care for neurosurgery patients through a nurse‐led transition feeding protocol

Dux

Lim

Jeffree

et al. 2019

Nutrition & Dietetics

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Aim Neurosurgical patients often transition from enteral nutrition (EN) to oral nutrition (ON) as they recover. Implementing a nurse‐led feeding protocol to guide this transition may improve consistency of nutrition care and dietitian workload efficiency. This pragmatic study aimed to evaluate the effect of such a protocol on these outcomes and on nurses’ nutrition care attitudes, practices and knowledge. Methods Data were collected retrospectively for 1 year pre‐ and prospectively for 1 year post‐implementation of the transition feeding protocol (TFP). Participants who transitioned from EN to ON were included in the study. Post‐implementation nurses in the neurosurgery ward were invited to complete a self‐administered questionnaire to investigate attitudes, practices and knowledge. Results One hundred and thirteen participants, 55 pre‐ and 58 post‐implementation, took part in the study. Significantly more patients received transition feeding (TF) post‐implementation (58% vs 93%, P < 0.001), there was a statistically significant improvement in the commencement of TF (0 vs 1 day after ON clearance; P = 0.029), and all patients consumed adequate oral intake 1‐week post‐EN cessation (92.3% vs 100%, P = 0.078). There was no difference in dietetic occasions of service post‐implementation (2 vs 1.5; P = 0.204). A 38% survey response rate from nursing staff (n = 15) was achieved. More nurses were found to be initiating TF (P < 0.001) and a majority reported a perceived increase in knowledge and confidence in providing nutrition support. Conclusions A TFP can optimise the transition from EN to ON by improving consistency and commencement of TF and nurses’ confidence and knowledge in overall nutrition care.

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“…Underfeeding is of concern because it has been associated with worse clinical outcomes, including mortality . Strategies to overcome nutrition deficits caused by interruptions have been developed to improve EN delivery …”

Section: Introductionmentioning

confidence: 99%

“…[11][12][13][14][15][16][17][18][19][20][21][22][23] Strategies to overcome nutrition deficits caused by interruptions have been developed to improve EN delivery. [24][25][26][27] Volume-based EN (VBEN) is one strategy used to compensate for EN interruptions. 24,[28][29][30][31][32][33][34][35][36] VBEN uses an order for 24 hours (eg, 1200 mL/24 h) vs the traditional hourly infusion rate with rate-based EN (RBEN; eg, 50 mL/h).…”

Section: Introductionmentioning

confidence: 99%

Volume‐Based vs Rate‐Based Enteral Nutrition in the Intensive Care Unit: Impact on Nutrition Delivery and Glycemic Control

Roberts

Brody

Rawal

et al. 2018

J Parenter Enteral Nutr

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Improvement of enteral nutrition in intensive care unit patients by a nurse‐driven feeding protocol

Abstract: Adherence to guidelines regarding early start and timely escalation of EN can be improved if ICU nursing staff is responsible for translating it into action with the help of a written algorithm.

Cited by 38 publications

References 41 publications

Default options in the ICU

Default options in the ICU

Improving nutrition care for neurosurgery patients through a nurse‐led transition feeding protocol

Volume‐Based vs Rate‐Based Enteral Nutrition in the Intensive Care Unit: Impact on Nutrition Delivery and Glycemic Control

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