Research improves care of ventilated patients
In Intensive Care Units all around the world, even with the best of nursing and medical care, ventilated patients don’t always receive the nutrition that they need.
Two years ago, Redcliffe Hospital’s ICU improved its nutrition protocols for ventilated patients. ICU dietitian Alicia Wiese recognised this as an opportunity to support evidenced-based practice through publishable research.
“Ventilated and critically ill patients in an ICU setting often receive their nutrition through an enteral tube placed into their stomach or small bowel,” Ms Wiese said.
“Nurses and medical staff make every effort to meet a patient’s goal energy and protein requirements during their ICU stay, but many ICUs are still following protocols that rely on the measurement of gastric residual volume (GRV) despite there being no evidence to support
this practice.
“Our ICU at Redcliffe became the first in Australia to move away from the use of GRV testing. Along with supporting our patients better, this has led to the first published research around both the removal of GRV monitoring and enteral nutrition rate titration.”
With the support of other ICU clinicians and Nutrition and Food Services at Redcliffe Hospital, Alicia designed a research project that analysed the nutritional and other outcomes of ventilated patients under the new protocol, comparing it retrospectively with patients back to 2014. That comparison showed patients were faring much better under the new protocol.
“The research confirmed that our patients are benefiting from more enteral nutrition without increasing gastrointestinal intolerance. Patients are also benefiting from a decreased need for prokinetics and the side effects that can come with those medications.”
In conducting the research, Ms Wiese says Dr Emma Ballard from the QIMR Berghofer Medical Research Institute was of great support and assistance.
“This was my first research project. Dr Ballard came on board initially to help me out with the study design and data analysis, but ended up acting as a research mentor for me.
“I’m also grateful to have received funding from the Redcliffe Hospital Private Practice Trust Fund Advisory Committee.”
Ms Wiese’s research now has also been accepted for publication in the Australian Critical Care Journal.
“The paper is on line and currently in press. I also presented the abstract at the 2018 Australasian Society for Parenteral and Enteral Nutrition Conference,”
Ms Wiese said.
“Hopefully this research will encourage and support other ICUs to make a similar change to their protocols, and move away from the use of GRV monitoring.”
