Enteral Nutrition in Adult Patients in the Critical Care Patients
Date
2015-07-23Author
Blodgett, Mindy
Iverson, Lindsay
Jackman, Paul
Ziesman, Melissa
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ABSTRACT
Guidelines have been established on when to initiate enteral nutrition, but current research indicates multiple inconsistencies. This scholarly project sought to determine when health care providers were initiating enteral nutrition for adults 19 years of age and older in the critical care setting. It explored if there was a correlation between the timing of enteral nutrition and outcomes including length of stay, 30-day readmissions, mortality, and other clinical complications. A retrospective chart review was completed examining patients admitted or transferred into a 25-bed intensive care unit (ICU) between January 1, 2013 and June 30, 2013. A total of 104 charts were collected based on the billable procedure code enteral infusion/nutrition, with 55 being eligible. The average number of days in the ICU was 3.3 days before enteral nutrition was initiated. The timing of when enteral nutrition was started had no statistical significance on mortality (p=0.54, 95% CI), 30-day readmissions (p= 0.58, 95% CI) or ICU length of stay (p= 0.20, 95% CI). Although the results of this scholarly project do not provide clear indication for early enteral nutrition, it does recognize some challenges to the current standards for recognizing, diagnosing, and treating malnutrition in the critical care setting. Future studies would benefit from a prospective study in order to standardize processes related to nutrition. Standardized processes and a larger sample size would perhaps lead to improved quality of data.
Guidelines have been established on when to initiate enteral nutrition, but current research indicates multiple inconsistencies. This scholarly project sought to determine when health care providers were initiating enteral nutrition for adults 19 years of age and older in the critical care setting. It explored if there was a correlation between the timing of enteral nutrition and outcomes including length of stay, 30-day readmissions, mortality, and other clinical complications. A retrospective chart review was completed examining patients admitted or transferred into a 25-bed intensive care unit (ICU) between January 1, 2013 and June 30, 2013. A total of 104 charts were collected based on the billable procedure code enteral infusion/nutrition, with 55 being eligible. The average number of days in the ICU was 3.3 days before enteral nutrition was initiated. The timing of when enteral nutrition was started had no statistical significance on mortality (p=0.54, 95% CI), 30-day readmissions (p= 0.58, 95% CI) or ICU length of stay (p= 0.20, 95% CI). Although the results of this scholarly project do not provide clear indication for early enteral nutrition, it does recognize some challenges to the current standards for recognizing, diagnosing, and treating malnutrition in the critical care setting. Future studies would benefit from a prospective study in order to standardize processes related to nutrition. Standardized processes and a larger sample size would perhaps lead to improved quality of data.