University thesis:
Dissertation, Universitätsmedizin der Universität Greifswald, 2020
Footnote:
Literaturverzeichnis: Seite 59-71
Text deutsch, Anhang englisch
Description:
Ernährung
A negative energy balance is associated with an increased rate of complications and a worse prognosis in ICU patients. Non-use of the intestine leads to a loss of gut integrity and increases bacterial translocation and infection rates. The guidelines recommend starting enteral nutrition in critically ill patients within 24h after admission to the ICU if no contraindications exist. However, in daily practice enteral nutrition is often not applied as recommended, for example the enteral nutrition started too late or wasn´t escalated to a sufficient amount. The present dissertation investigates by a before-and-after-analysis the effect of assigning the responsibility for initial enteral nutrition to the nursing staff. After an extensive training and a modification of the existing nutrition protocol, the responsibility for starting and timely escalation enteral nutrition was transferred to the nursing staff. After the intervention we recognized a significant improvement of the enteral nutrition quality. The intervention group started enteral nutrition significant earlier. Days per patient without any enteral nutrition were significantly less after intervention than before. After the intervention adequacy of energy administration improved and the average daily intake of calories was significantly higher. In summary implementation a nurse-driven feeding protocol improves the enteral nutrition quality at the internal ICU of the Greifswald University Medical Center.