Increasing the Volume of Delivered Enteral Feeds Using a Volume-Based Feeding Protocol in a Neuroscience Intensive...

Area of Science:

• Critical Care Medicine
• Clinical Nutrition
• Quality Improvement Science

Background:

• Iatrogenic malnutrition significantly impacts patient outcomes and healthcare costs.
• Underfed patients (receiving <80% of energy needs) experience worse nutritional status and adverse events.
• Current feeding protocols may lead to inadequate nutrient delivery in intensive care units.

Purpose of the Study:

• To evaluate the impact of a volume-based enteral feeding protocol on nutrient delivery in a neuroscience intensive care unit.
• To assess the effect of a nutrition-focused project on healthcare staff attitudes towards nutrition in critical care.
• To compare the efficacy of volume-based versus rate-based feeding protocols in achieving target enteral nutrition delivery.

Main Methods:

• A before-and-after study design was employed to assess the clinical practice change.
• A volume-based feeding protocol was implemented and compared to a previous rate-based protocol.
• Staff attitudes regarding nutrition were surveyed pre- and post-implementation.

Main Results:

• Implementation of the volume-based protocol increased the percentage of delivered enteral feeding volume.
• The proportion of feeding days where patients received at least 80% of prescribed nutrition improved.
• Post-implementation, staff reported increased emphasis on nutrition delivery and recognized its priority.

Conclusions:

• A volume-based enteral feeding protocol, supplemented with staff education, effectively improved the delivery of prescribed nutrition.
• This quality improvement initiative enhanced the delivery of essential nutrients to critically ill patients.
• The project demonstrated a positive shift in staff perception and practice regarding nutritional support.