State of the Sciene

Enteral Nutrition Protocols

Abstract

Managing nutrition in critically ill patients is an important intervention to promote healing. Adequate nutrition decreases rates of infections and pressure ulcers, improves prognosis for recovery, and decreases mortality. The purpose of this literature review is to determine the current state of the science in regards to evidence-based protocols for the administration and management of enteral nutrition (EN) in critically ill patients. Is the use of a nursing-driven protocol for enteral feeding in critically ill patients effective in improving patient outcomes compared with not utilizing a protocol? Ten studies with enteral nutrition protocols for adult, critically ill patients were included for review. Study characteristics and themes are identified. Early initiation of EN and adequate titration to goal are important for achieving the maximum nutritional advantage. The highest benefit is also derived from identifying and delivering an individualized caloric and/or protein goal. Interprofessional collaboration remains paramount, and an EN protocol increases standardization of practice. A nurse-driven protocol may yield higher compliance and greater effectiveness than a protocol that is not nurse-driven. Lastly, gaps in knowledge, future research opportunities, and applications to nursing administration, research, education, and practice are discussed.