Do Patients in the Intensive Care Unit Receive Recommended Total Daily Calories with Enteral Feedings Using a Rate Based Protocol?

When a patient is unable to eat or eat enough nutrients due to an illness or surgery, nutrition from another source may be required. Supplemental nutrition may be given in the form of enteral nutrition. The current practice is delivering enteral feedings on a rate based protocol to deliver calculated required calories over a specific length of time. Patients who receive enteral nutrition may have feedings interrupted due to a variety of reasons such as a procedure or diagnostic exam. Interruptions reduce the total daily calories delivered. If a patient does not achieve their total daily calories, it can be detrimental to the patient’s health and may increase length of stay and costs of hospitalization. The purpose of this study was to determine if patients receive their recommended total daily calories of enteral nutrition using a rate based protocol. A retrospective research design was used to obtain data from patients who received enteral feedings while in the Intensive Care Unit. Data were collected on patients who were admitted to the unit between June 1, 2014 and August 31, 2014. 41 patients who received enteral feedings were included in this study. 80% of patients had their enteral feedings interrupted; most frequent reasons included diagnostic testing, residual volumes and procedures. Interruptions of the enteral feedings lasted between one hour and 24 hours in duration with a mean of 2.9 hours. The most frequent duration of interruption was one hour. Patients received a mean of 56.4% of their daily prescribed goal calories and 56.7% of their daily prescribed volume of enteral feedings. This study suggests that patients do not receive their daily prescribed calories using a rate based protocol. Recommendations for further research and advanced nursing practice are discussed