Implementation of an Enteral Nutrition Tool to Prevent Underfeeding in Intensive Care Patients
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Authors
Zimmer, Rachel
Issue Date
2022-05-12
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Abstract
Purpose: This quality improvement project examined the effect of a standardized feeding protocol to assess feeding intolerance on nutritional intake in critically ill patients receiving enteral nutrition (EN).|Background: Malnutrition in critically ill patients leads to increased morbidity in mortality in patients. Patients in the ICU may not be receiving adequate nutrition because enteral nutrition (EN) is often withheld for gastric residual volumes (GRVs) >250mL and little to no other assessments are being conducted for feeding intolerance by nurses, even though national guidelines recommend otherwise.|Sample/Setting: Preintervention, the initial sample size included 30 patients. Demographically, there were 15 females and 15 males ranging from ages 29 years old to 83 years old. Postintervention, there was an initial sample size of 28 patients. There were 12 females and 16 males ranging in ages 23 to 83 years old.|Methods: A pre-post quality improvement project design was implemented examining rates and frequencies of withholding EN in ICU patients prior to and after implementation of the feeding intolerance protocol. Data prior to and after the protocol implementation was then analyzed. Comparisons were made pre-intervention and post-intervention.|Results: Preintervention, 68% of patients had a GRV checked more than half of the days they received EN, and 77% of patients received less than 80% of the recommended goal volume of EN on more than half the days. Postintervention, only 29% of patients had a GRV checked more than half of the days they received EN, and 66% of patients received less than 80% of the recommended goal volume of EN on more than half the days.|Conclusion: Patients included in this study had improved EN intake when GRV was not checked. Policy change is recommended to update current GRV protocols with evidence-based practice.
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Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University