Review : nurses can improve patient nutrition in intensive care

Ros, Caroline, McNeill, Liz and Bennett, Paul 2009, Review : nurses can improve patient nutrition in intensive care, Journal of clinical nursing, vol. 18, no. 17, pp. 2406-2415, doi: 10.1111/j.1365-2702.2008.02765.x.

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Title Review : nurses can improve patient nutrition in intensive care
Author(s) Ros, Caroline
McNeill, Liz
Bennett, PaulORCID iD for Bennett, Paul
Journal name Journal of clinical nursing
Volume number 18
Issue number 17
Start page 2406
End page 2415
Total pages 10
Publisher Wiley-Blackwell Publishing Ltd
Place of publication Oxford, England
Publication date 2009-09
ISSN 0962-1067
Keyword(s) critical
intensive care
Summary Aims and objectives. To review the literature and identify opportunities for nutritional practice improvement in the critically ill and opportunities to improve nurses’ knowledge relating to enteral feeding.

The literature reports varying nutritional practices in intensive care.

Systematic review.

A systematic search, selection, analysis and review of nursing, medical and dietetic primary research articles was undertaken. Fifteen studies met the selection criteria.

Delivery of nutrition to the critically ill varied widely. Patients were frequently underfed and less frequently, overfed. Both under- and overfeeding have been linked with unacceptable consequences including infections, extended weaning from mechanical ventilation, increased length of stay and increased mortality. Underfeeding was related to slow initiation and advancement of nutrition support and avoidable feed interruptions. The most common reasons for interrupting feeds were gastrointestinal intolerance and fasting for procedures. Certain nursing practices contributed to underfeeding such as the management of gastric residual volumes.

Conclusions. Consistent and reliable nutrition support in intensive care units is hampered by a lack of evidence leading to varying nutrition practices. Factors impeding delivery of enteral nutrition were considered avoidable. A new concept of a therapeutic range of energy delivery in the critically ill has emerged implying the need for re-evaluation of energy recommendations and improved delivery of enteral nutrition.

Relevance to clinical practice. This review supports the multi-disciplinary development and implementation of an evidence-based enteral feeding protocol in intensive care units as a strategy to improve adequacy of nutritional intake. Critical care nurses are well placed to improve this process.
Language eng
DOI 10.1111/j.1365-2702.2008.02765.x
Field of Research 110312 Nephrology and Urology
Socio Economic Objective 920199 Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2009, The Authors
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Document type: Journal Article
Collection: School of Nursing and Midwifery
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