Improving Critical Thinking and Nursing Outcomes Through an Evidence-Based Nutritional Protocol in Critically Ill...

This study is a single-center quasi-experimental study.

This study aimed to develop an evidence-based nutritional management protocol for critically ill patients and evaluate its impact on junior nurses' critical thinking and nursing quality.

Patients and junior nurses were assigned to the study or control group according to the study implementation schedule. The study group received the evidence-based nursing (EBN) protocol with structured training, while the control group received conventional care. Outcomes included nurses' critical thinking skills assessed via the Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV), patient nutritional biomarkers (serum albumin, prealbumin), complication rates (aspiration, diarrhea, abdominal distension), and patient satisfaction.

The study included 7 junior nurses in each group and a total of 84 critically ill patients (42 per group). We developed a nutritional management protocol through evidence synthesis, expert consultation, and revisions. This protocol demonstrated preliminary clinical applicability, offering a structured framework for EBN practice in critical care. After training, the study group showed a significantly greater improvement in critical thinking scores than the control group (mean increase: 12 vs 3 points; t=2.417, P < 0.05). We observed no significant intergroup differences in aspiration, diarrhea, abdominal distension, weight, systolic blood pressure, or blood glucose (all P > 0.05). However, the study group showed superior serum albumin, prealbumin, and patient satisfaction (P < 0.01).

Within the limitations of a small sample size and single-center design, this EBN-based protocol demonstrated potential to enhance junior nurses' specialized critical thinking and improve patient nutritional outcomes and satisfaction. These preliminary findings suggest potential value for optimizing critical care quality. We recommend further validation through larger multicenter studies with extended follow-up before considering widespread adoption.