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theses

Purpose: To explore the impact of volume-based feeding versus continuous feeding on the risk for aspiration in critically ill patients, in the intensive care unit. Utilizing nurse driven volume-based protocols tend to increase enteral nutrition delivery, which will positively impact patient outcomes by reducing the incidence of infections acquired from aspiration.
Methodology: A pre/post-test evaluation to evaluate knowledge after an educational session will be given to the nursing staff to assess their knowledge of volume-based feedings. A chart review will look at variables to evaluate contributing factors to aspiration in enterally fed patients such as age, gender, type of feeding, level of consciousness, use of sedation, presence of tracheostomy or endotracheal tube, gastric residual volume, vomiting, and location of feeding. A total of 55 charts will be reviewed over 3 months retrospectively looking at these variables when receiving continuous based feedings and 3 months prospectively looking at these variables when receiving volume-based feedings. Based on the data distribution, the relationships between the two groups will be determined with parametric or nonparametric statistics, with a significance level of 0.05. The pre-test and post-test scores will also be compared using mean values.
Results: There was a higher incidence of aspiration in patients receiving continuous based feedings. Overall patient aspiration receiving continuous based feedings, was 69% compared to 11% of patients receiving volume-based feedings. There was a very high strength of association between both groups and aspiration resembled by a p-value of 0.002, which is statistically significant.
Implications for Practice: It is anticipated that after determining volume-based feedings reduced the risk for aspiration in critically ill patients, clinicians will be inclined to primarily utilize this method of feeding over others. Implementing volume-based feeding as the standard of care will continue to reduce aspiration and avoid unforeseen costs due to complications. Critically ill patients are already severely compromised and being able to reduce their risk for aspiration may therefore reduce recovery time and increase overall outcomes. In the future, the vision is to bring continuing success to critically ill patients who are in need of enteral nutrition with a more efficient way of delivery and maintenance, using volume-based feedings.

ETD_9556

DNP

Includes bibliographical references

doi:10.7282/t3-478y-3e88

ETD doctoral

The author owns the copyright to this work.