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Topical Area: Medical Nutrition/Case Study Vignettes

Medical Nutrition/Case Study Vignettes (Poster Session)

(P08-020-23) Interruptions for Enteral Nutrition Provision in Critically Ill Patients

Saturday, July 22, 2023
12:00 PM – 1:00 PM ET
Location: Poster Board 102

    Presenting Author(s)

  • AS

    Alana Schipper, MS

    University of Arkansas for Medical Sciences
    Little Rock, Arkansas, United States

    • Co-Author(s)

  • JP

    Josh Phelps, Ph.D

    University of Arkansas

  • WL

    Wei Li, PhD

    Assistant Professor
    University of Arkansas for Medical Sciences
    Little Rock, Arkansas, United States

  • Reza Hakkak, PhD

    Professor
    University of Arkansas for Medical Sciences
    Little Rock, Arkansas, United States

Disclosure(s):
Wei Li, PhD: No relevant financial relationship(s) with ineligible companies to disclose.
Reza Hakkak, PhD: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: Enteral nutrition (EN) is the preferred method of nutrition support for critically ill patients. However, there are some factors that may hinder the provision of prescribed nutrition. EN interruptions (ENIs) may be patient specific or associated with day-to-day aspects of care. The objective of this study was to evaluate potential ENIs in the daily delivery of EN in critically ill patients, and to determine if any interruptions are avoidable.

Methods: This was an observational study conducted in a medical intensive care unit (ICU) between November 2021 and March 2022. It included adult patients (N=54) who received EN during the ICU admission. Data collected included EN delivery timeline and ENI causes and hourly interruption rates. Descriptive statistics were used to define patient characteristics, and number and type of ENIs per ICU stay. A Kaplan-Meier estimate was conducted to visualize the risk of an ICU patient experiencing at least one ENI.

Results: In total, 54 patients were enrolled in the study. Within the five-month period, 146 individual ENIs were documented. Approximately 70% of patients experienced at least one ENI during the ICU stay. The main reasons for ENI were nursing related inaccuracies (34.2%), GRV < 500mL (15.8%), feeding tube dislodgement (9.6%), and surgery or other procedures (11.6%). Total hourly interruption time was 2241 hours with nursing related interruptions accounting for 46.6%. There were 77 (52.7%) interruptions deemed avoidable, and 66 (45.2%) interruptions deemed unavoidable.

Conclusions: Critically ill ICU patients experienced frequent and prolonged interruptions to EN delivery, which were influenced by multiple facets of ICU care. Greater than 50% of these interruptions were considered avoidable; therefore, implementation of a facility-wide standardized feeding protocol is needed to address these barriers to EN delivery.

Funding Sources: Department of Dietetics and Nutrition