Improving the Delivery of Enteral Nutrition in the Neurocritical Care Unit Through the Implementation of a Volume-Base Feeding Protocol

Abstract

Neurocritical care patients receiving rate-based enteral nutrition (RBEN) consistently received less than their full prescription of enteral nutrition (EN) volume due to interruptions in feeding. This study investigated the impact of the implementation of a volume-based feeding protocol (VBEN) on the percentage of prescribed volume of EN delivered over the course of patients’ neurocritical care unit (NCCU) length of stay. Aim: The aim of this study was to better meet the nutritional needs of adult neurocritical care patients receiving nutrition through the enteral route. Methods: A retrospective pre and postimplementation chart review was conducted on adult patients with age 18 or greater and less than 90 years with a neurological-related injury or disease process who had EN initiated and delivered for three or more days during their stay in NCCU. Results: Despite no significant differences in characteristics or gastrointestinal complications between the groups, there was a significant increase in the percentage of prescribed EN volume delivered over the course of NCCU stay of 23.15% percentage points in the VBEN group (M = 95.3%, SD 4.92) as compared to the RBEN group (M = 72.15%, SD 10.55, t(27, n=40) = 8.89, p