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Implementation of an evidence-based feeding protocol and aspiration risk reduction algorithm
Amy Bowman1, Joseph E Greiner, Kevin C Doerschug
1Intensive and Speciality Services Division, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. amy-bowman@uiowa.edu
Insights
Implementing an evidence-based enteral feeding protocol and aspiration risk algorithm reduced pneumonia complications in critically ill patients. This initiative improved feeding tolerance and decreased hospital-acquired infections, enhancing patient outcomes.
Area of Science:
- Critical Care Medicine
- Infectious Disease Prevention
- Evidence-Based Practice
Background:
- Aspiration pneumonia is a severe complication linked to mechanical ventilation and enteral tube feeding.
- This condition significantly increases patient mortality, hospital stay duration, and healthcare expenses.
Purpose of the Study:
- To describe the development and implementation of an evidence-based enteral feeding protocol.
- To introduce an algorithm for reducing aspiration risk in intensive care settings.
Main Methods:
- An evidence-based practice approach was used to create the protocol and algorithm.
- These tools were piloted in a Medical Intensive Care Unit at a Midwest tertiary care center.
- Chart audits were conducted to assess the impact of the interventions.
Main Results:
- The percentage of patients achieving their goal enteral feeding rate increased from 78% to 85%.
- Reported cases of aspiration pneumonia decreased from 4.8 to 4.3 patients per month.
- Ventilator-associated pneumonia rates declined from 6.8 to 3.2 per 1000 patient days.
Conclusions:
- The developed enteral feeding protocol and aspiration risk reduction algorithm are effective in improving patient outcomes.
- These evidence-based tools can reduce the incidence of aspiration pneumonia and ventilator-associated pneumonia in the ICU.
- Implementation of such protocols is crucial for enhancing patient safety and reducing healthcare costs.
Abstract:
Aspiration pneumonia is a serious complication of mechanical ventilation and enteral tube feedings. It results in increased patient mortality, increased length of hospital stay, and increased healthcare costs. This article describes an evidence-based practice approach to the creation of an enteral feeding protocol and an aspiration risk reduction algorithm. These tools were piloted in a Medical Intensive Care Unit at a Midwest tertiary care center. Chart audits show an increase in the percentage of patients who reach their goal rate for enteral feedings from 78% to 85%. Reported aspiration pneumonias decreased from an average count of 4.8 patients per month to 4.3 per month and ventilator-associated pneumonia rates decreased from 6.8 to 3.2 per 1000 patient days.
