Development of a multidisciplinary cooperative nutrition management process for critically ill patients-a Delphi...

To explore a multidisciplinary cooperative nutrition management process for critically ill ICU patients in China for providing a standardized nutrition management process and improving the effect and safety of nutritional support.

Our first draft of the "multidisciplinary nutrition management process for critical patients" and "enteral nutrition management process for critical patients", which included five steps and 31 criteria, was prepared through literature review and analysis, referring to the domestic and foreign nutrition management guidelines for critical patients, and referring to the nutrition management process for critically ill patients abroad. We recruited consulting experts from Beijing, Zhejiang, Jilin, Guangdong, and Chongqing in China. Using the Delphi method, we conducted expert consultations to evaluate the initially prepared standardized process, subsequently refining and adjusting items based on their feedback.

After two rounds of expert consultation, all 20 invited experts completed both rounds, 15 experts provided written opinions, and 43 expert opinions were collected. The nutrition management process was bifurcated into "multidisciplinary nutrition management process for critically ill patients" and "enteral nutrition management process for critically ill patients," which collectively included five steps (within 24 h of admission, within 24-48 h of admission, after 48 h of admission and during hospitalization, during transfer to another department, and during discharge) and 31 standard processes. The 31 criteria were rated as desirable or necessary by 17-20 evaluators (85-100%).

The multidisciplinary cooperative nutrition management process for critically ill patients established by us using the Delphi method is scientific and standardized and shows promise as a practical tool that may improve for nutritional management.

Structured multidisciplinary nutrition management operational processes can guide clinical practice. They has potential for implementation in similar settings in the clinical nutrition management of critically ill patients in the ICU or other departments.