Enteral nutrition feeding practices by intensive care nurses: A retrospective evaluation

Abstract

Background: Enteral nutrition (EN) is an integral component of standard management of critically ill patients in intensive care. However, achieving adequate nutrition in this environment continues to present many challenges.Design: A descriptive exploratory design using a retrospective review of medical records. Aims and objectives:The aims of this study were to describe nursing practice associated with EN feeding and identify barriers to optimal nutritional delivery in the intensive care unit (ICU).Methods: Patients admitted to a major Australian metropolitan health service ICU during a 6-month period, and who received EN for at least 72 hours, were eligible for inclusion. Documented text from patient medical records was analysed using content analysis. Numerical data were analysed using SPSS software (version 25.0). Descriptive and inferential statistics were calculated.Results: A total of 150 patients were included in the study. The mean time from admission to EN commencement was 12.6 hours, with 59.3% commenced within 12 hours of admission. Only 9.3% of patients commenced EN at the target rate. Of the 150 patients, 24 (16%) received 80% of nutrition targets within 72 hours of admission. Patients who had EN commenced within 12 hours of admission and at the target rate were significantly more likely to achieve nutritional requirements (P = <.01). Patients who received an initial dietitian review within 24 hours of admission were more likely to achieve nutrition requirements (P = <.01). Conclusions:Commencing EN on time and meeting target volumes remains challenging in the ICU patient. Airway management, procedural requirements, and delayed dietitian review for prescribed hourly rate initiation provide barriers to optimal nutrition delivery to critically ill patients. Tackling these barriers may require interdisciplinary interventions.Relevance to clinical practice: Providing adequate nutrition to critically ill patients is challenging. This study provides evidence that day's one and two are problematic to EN delivery; particularly concerning airway management, procedural requirements,

Construction of a three-level enteral nutrition nursing system under the “Internet + medical” mode and an evaluation of its effect in clinical application

“…Clinical reports show that, due to the depletion of diseases and patients' insufficient nutritional intake, the number of patients with malnutrition is increasing ( 3 ). However, through the construction of a normalized and standardized enteral nutrition nursing system, professional services can be provided for clinical nutrition evaluation, implementation, observation, nursing, and follow-up family nutrition management, which can greatly improve the effect of nutritional treatment ( 4 , 5 ).…”

An evaluation of intensive care nurses' performance of indirect calorimetry measurements

“…Nutritional management covers a wide range of actions and therefore requires multi‐professional management. Crossfield et al showed that early assessment by a dietician and the development of a nurse‐led decision algorithm allowed earlier initiation of nutritional support and could improve nutrition delivery to ICU patients 13 . As a result of the lack of human resources in our institution, no dietician is assigned to our service despite many requests.…”

“…showed that early assessment by a dietician and the development of a nurse-led decision algorithm allowed earlier initiation of nutritional support and could improve nutrition delivery to ICU patients. 13 As a result of the lack of human resources in our institution, no dietician is assigned to our service despite many requests. The whole team (nurses, auxiliaries, physiotherapists and doctors) had to commit to providing the most appropriate nutrition-related care.…”

Intensive care nurses' knowledge and use of a nursing checklist: A cross‐sectional survey

“…According to the results, it was reported that 45.5% of the nurses had knowledge about feeding at the rate of 50% to 75% (Jamshidi et al, 2020). In other studies, it was stated that most of the ICU nurses do not have enough knowledge about enteral feeding and this may result in malnutrition in the patients (Crossfield et al, 2022; Darawad et al, 2018). It was observed that there are differences between studies in the literature.…”