Use and safety of enteral nutrition protocols in acute care: A scoping review of literature and retrospective audit of practice

Use and safety of enteral nutrition protocols in acute care: A scoping review of literature and retrospective audit of practice

Aim Standardised enteral nutrition protocols are recommended in critical care, however their use and safety are not well described in other inpatient populations. This mixed methods study reports on the use and safety of enteral nutrition protocols for non‐critically ill adults. Methods A scoping re...

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Published in:Nutrition & dietetics Vol. 81; no. 1; pp. 51 - 62
Main Authors: Byrnes, Angela, Glen, Kate, Matthews‐Rensch, Kylie, Fry, Jessica, MacLaughlin, Helen, Cutmore, Clare, Dux, Claire, Treleaven, Elise, Banks, Merrilyn, Hiatt, Joanne, Wu, Yuet Ching, Wan, Yuen Ting Jessie, Young, Adrienne
Format: Journal Article
Language:English
Published: Melbourne John Wiley & Sons Australia, Ltd 01-02-2024
Wiley Subscription Services, Inc
Subjects:
acute care
Adult
Australia
care pathways
Clinical outcomes
Critical care
Critical Care - methods
Critical Illness
Enteral nutrition
Enteral Nutrition - adverse effects
Enteral Nutrition - methods
Humans
Inpatient care
nursing protocols
Nutrition
nutrition support
Nutrition therapy
Retrospective Studies
Review Literature as Topic
Australia
enteral nutrition
care pathways
nutrition support
acute care
nursing protocols
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Summary:Aim Standardised enteral nutrition protocols are recommended in critical care, however their use and safety are not well described in other inpatient populations. This mixed methods study reports on the use and safety of enteral nutrition protocols for non‐critically ill adults. Methods A scoping review of published literature was conducted. In addition a retrospective audit of practice at an Australian tertiary teaching hospital with an existing hospital‐wide standardised enteral nutrition protocol was performed. Data on use, safety and adequacy of enteral nutrition prescription were collected from medical records for patients receiving enteral nutrition on acute wards (January–March 2020). Results Screening of 9298 records yielded six primary research articles. Studies were generally low quality. Published literature suggested that protocols may reduce time to enteral nutrition initiation and goal rate, and improve adequacy of nutrition provision. No adverse outcomes were reported. From the local audit of practice (105 admissions, 98 patients), enteral nutrition commencement was timely (median 0 (IQR 0–1) days from request; goal rate: median 1 (IQR 0–2) days from commencement and adequate (nil underfeeding), without prior dietitian review in 82% of cases. Enteral nutrition was commenced per protocol in 61% of instances. No adverse events, including refeeding syndrome, were observed. Conclusions Most inpatients requiring enteral nutrition can be safely and adequately managed on enteral nutrition protocols. Evaluation of protocols outside of the critical care setting remains a gap in the literature. Standardised enteral nutrition protocols may improve delivery of nutrition to patients, whilst allowing dietitians to focus on those with specialised nutrition support needs.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:1446-6368
1747-0080
DOI:10.1111/1747-0080.12819