Objectives: The goal of this project was to evaluate and improve the ordering, administration, documentation, and monitoring of enteral nutrition therapies within the inpatient setting in a Veteran's Health Administration system.Methods: An interdisciplinary team of clinicians reviewed the literature for best practices and revised the process for enteral nutrition support for hospitalized veterans. Interventions included training staff, revising workflows to include scanning patients and products, including enteral nutrition orders within the medication administration record (MAR), and using the existing bar code medication administration system for administration, documentation, and monitoring. Baseline and postprocess improvement outcomes over a year period were collected and analyzed for quality improvement opportunities.Results: Before process change, only 60% (33/55) of reviewed enteral nutrition orders were documented and 40% (22/55) were not documented in the intake flowsheet of the electronic health record. In the year after adding enteral nutrition therapies to the MAR and using bar code scanning, a total of 3807 enteral nutrition products were evaluated. One hundred percent of patients were bar code scanned, 3106/3807 (82%) products were documented as given, 447/3807 (12%) were documented as held (with comments), 12/ 3807 (<1%) were documented as missing/unavailable, and 242/3807 (6%) were documented as refused.Conclusions: Inclusion of enteral nutrition order sets on the MAR and using bar code scanning technology resulted in sustained improvements in safety, administration, and documentation of enteral therapies for hospitalized veterans.

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only provided in a hospice facility (60.6%). A minority knew that palliative care can be provided alongside life-prolonging treatment (29.8%) and that palliative care is not only for people who have a few weeks left to live (23.5%). Higher education level (OR ranging from 1.34 to 4.67 for the four statements), personal experience with palliative care (ORs from 1.35 to 2.44), being female (ORs from 1.00 to 1.88), and higher income (ORs from 0.95 to 1.81) were positively associated with knowledge about palliative care, while increasing age (ORs from 0.51 to 0.68) was negatively associated. Conclusions Knowledge of palliative care is limited, stressing the need for population-wide interventions, such as information meetings. During such meetings, attention should especially be paid to timely utilization of palliative care. This might stimulate engagement in ACP and raise public knowledge of (im)possibilities of palliative care.

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