Nutrition Support Protocols and Early Feeding in the Intensive Care Unit
Background: While many studies have documented the importance of providing nutrition support in the critical care setting within 48 hours of Intensive Care Unit (ICU) admission in order to minimize undesirable clinical outcomes and malnutrition, few studies have reviewed how to achieve those recommendations. The present study will provide evidence on whether or not the implementation of a voluntary Nutrition Support Protocol across a healthcare system will shorten time to nutrition initiation and increase the number of patients who received nutrition within 48 hours.
Methods: The Nutrition Support Protocol was developed in support of evidence-based recommendations under the leadership of a critical care Registered Dietitian (RD). Data was collected via medical chart review over a near three year time period. Changes in the time of nutrition initiation were compared between the pre-and post-protocol implementation periods. In the post-protocol implementation period, different methods of administering nutrition (enteral, parenteral or oral) were compared along with the time to the initiation of nutrition, total percent of patients who received nutrition within 48 hours, and whether or not the nutrition was managed by the physician or utilizing the Nutrition Support Protocol (RD leadership). Differences between groups (pre-protocol versus post-protocol implementation periods and physician managed versus Nutrition Support Protocol managed) were tested using analysis of variance (ANOVA) and Wald's Chi Square.
Results: The time to nutrition initiation significantly decreased from the pre-protocol to the post-protocol period, 36.3 ± 31.5 hours versus 28.9 ± 25.3, p
Conclusions: The use of a nutrition management protocol for the initiation of nutrition support to critically ill patients significantly improved the number of patients receiving nutrition support within 48 hours and should be considered as part of standard practice in the ICU setting.
School:Bowling Green State University
School Location:USA - Ohio
Source Type:Master's Thesis
Keywords:nutrition support protocols icu enteral registered dietitian hosptial healthcare
Date of Publication:01/01/2008