Failure of a quality improvement process to increase nutrition delivery to intensive care patients

Anaesthesia and Intensive Care
S Ferrie, D McWilliam

Abstract

The importance of nutrition support in intensive care has been recognised, but many factors may limit successful provision of patients' requirements. We conducted a twelve-month prospective audit, with intervention after six months, to determine whether longer-stay (> 3 days) patients in our intensive care unit were receiving their nutritional requirements and to identify and improve factors limiting nutrition provision. Data was collected for 379 consecutive patients admitted to intensive care longer than three days. Total energy provided to each patient was recorded daily and compared with the predicted requirement. In the first six months, patients commenced nutrition 2.2 +/- 1.3 days after intensive care admission and were receiving 100% of predicted energy requirement by 4.8 +/- 3.3 days. Patients received nutrition on 82.3% of total patient-days, daily average 71.7% (43.2) of their energy requirement. Nutrition was interrupted on 30% of total patient-days. After six months, a Clinical Practice Improvement model was used to analyse reasons for inadequate feeding and introduce changes in practice. Main reasons for interruption included preparation for extubation and upper gastrointestinal intolerance. After intervention, in...Continue Reading

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Citations

Jun 23, 2009·Journal of Clinical Nursing·Caroline RosPaul Bennett
Oct 19, 2012·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Nicola DervanClare Corish
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Dec 24, 2020·Critical Care Explorations·Molly McNettMichele C Balas

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