Varying practices and frequent lapses in nutrition delivery can put critically ill patients at greater risk for malnutrition and associated complications, according to an article in the August issue of Critical Care Nurse.
Interruptions in Enteral Nutrition Delivery in Critically Ill Patients and Recommendations for Clinical Practice, by Melissa L. Stewart, RN, DNP, MSN, CCNS, CCRN, a staff nurse in the medical ICU at the University of Kentucky Chandler Medical Center in Lexington, offers strategies to address underfeeding and decrease the time patients spend without nutrition, according to a news release.
Critical care nurses spend more time at the bedside than other healthcare providers and are well positioned to monitor nutrition delivery, Stewart said in the release. Malnutrition is common in critically ill patients and the use of a nutrition support protocol can help improve patients outcomes.
Stewart reviewed the latest research related to enteral nutrition, also known as tube feeding, which is the feeding method of choice for critically ill adult patients. Enteral nutrition often is interrupted because of positioning during procedures, technical issues with feeding accesses and gastrointestinal intolerance issues, which may lead to underfeeding.
Deteriorating nutritional status while hospitalized is strongly associated with prolonged length of stay, increased cost of hospitalization and higher mortality, according to the release. The article encourages the development and use of nutrition support protocols to offer guidance to bedside nurses when addressing common issues related to enteral nutrition such as the initiation of feedings and feeding intolerance as well as advancement and discontinuation of enteral nutrition.
Protocols are effective in increasing the amount of nutrients provided to critically ill patients and decreasing the amount of time necessary to reach target nutrition goals, according to the release.
The article encourages nurses to work with other members of the multidisciplinary team to develop and implement interventions to prevent and treat malnutrition including efforts to limit the amount of time nutrition delivery is interrupted because of procedures, according to the release.