Use of quality management to provide nutrition to intubated patients

CLINICAL NURSE SPECIALISTS are in a pivotal position to impact patient outcomes. Quality management is one method CNSs can use to measure and validate the effect they are having on patient outcomes. An example of such a quality management program was implemented by the CNS to monitor initiation of feeding for intubated patients. Because it was determined that many patients were not being fed for over 7 days after intubation, nutritional guidelines were developed and implemented for physicians and nurses to follow. One year after implementation of the guidelines, 51 patients were identified as needing nutritional support. The average number of days to institute feeding was reduced by a mean 6.4 days across all types of feeding, including oral feeding, enteral bolus feeding, continuous postpyloric feeding and parenteral nutrition. The early nutrition quality management program initiated by the CNS had a positive outcome for patients.