Implementation of an evidence-based feeding protocol and aspiration risk reduction algorithm.
Aspiration pneumonia is a serious complication of mechanical ventilation and enteral tube feedings. It results in increased patient mortality, increased length of hospital stay, and increased healthcare costs. This article describes an evidence-based practice approach to the creation of an enteral feeding protocol and an aspiration risk reduction algorithm. These tools were piloted in a Medical Intensive Care Unit at a Midwest tertiary care center. Chart audits show an increase in the percentage of patients who reach their goal rate for enteral feedings from 78% to 85%. Reported aspiration pneumonias decreased from an average count of 4.8 patients per month to 4.3 per month and ventilator-associated pneumonia rates decreased from 6.8 to 3.2 per 1000 patient days.
Bowman
Amy
A
Intensive and Speciality Services Division, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. amy-bowman@uiowa.edu
Greiner
Joseph E
JE
Doerschug
Kevin C
KC
Little
Susan B
SB
Bombei
Cheryl L
CL
Comried
Lynn M
LM
D000465:Algorithms; D002985:Clinical Protocols; D004750:Enteral Nutrition / Q000379:methods* / Q000451:nursing; D019317:Evidence-Based Medicine; D006284:Health Plan Implementation; D006801:Humans; D015146:Midwestern United States; D011015:Pneumonia, Aspiration / Q000517:prevention & control*; D015397:Program Evaluation; D012121:Respiration, Artificial; D012308:Risk Management / Q000458:organization & administration*