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The Impact of Implementation of a Nutrition Support Algorithm on Nutrition Care Outcomes in an Intensive Care Unit
Author(s) -
Kiss Caroline M.,
ByhamGray Laura,
Denmark Robert,
Loetscher Rene,
Brody Rebecca A.
Publication year - 2012
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0884533612457178
Subject(s) - medicine , intensive care unit , intensive care medicine , parenteral nutrition , unit (ring theory) , mathematics , mathematics education
Background: A nutrition support algorithm is an operational version of a guideline that is adapted to local requirements and easy to apply in clinical practice. The purpose of this study was to determine the impact of implementing a nutrition support algorithm on nutrition care outcomes in an intensive care unit (ICU) in Switzerland without a designated dietitian. Methods: The retrospective study included data collection on 2 cohorts of critically ill patients before (n = 56) and after (n = 56) implementation of a nutrition support algorithm based on the guidelines published by the Society of Critical Care Medicine and the American Society for Parenteral and Enteral Nutrition guidelines. Results: There were significant differences between groups for the mean delivery of total energy in the pre‐ vs postimplementation group (909 ± 444 vs 1097 ± 420 kcal/d; P = .023) and mean delivery of protein per day (35 ± 17.9 vs 59.1 ± 27.3 g; P < .001). For patients staying at least 7 days in the ICU, the cumulative energy deficit decreased from −5664 ± 3613 kcal in the preimplementation group to −2972 ± 2420 kcal ( P = .011) in the postimplementation group. No significant differences in the route of feeding and timing of enteral nutrition initiation were found. Conclusions: Implementation of a nutrition support algorithm resulted in improved provision of energy and protein delivery. This may be further improved with routine nutrition assessment by a dietitian or a designated nutrition support team.