title: Evaluation of current feeding practices in the critically ill: A retrospective chart review.
abstract: BACKGROUND
  Worldwide, malnutrition is an important issue in the care of the critically ill which is associated with increased costs of care and poor patient outcomes.
  
  
  OBJECTIVE
  To evaluate the current state of enteral nutrition in the critically ill in the U.S. in comparison to international practices.
  
  
  METHODS
  A retrospective chart audit was performed utilising a 10% random sample of patients admitted to the Pulmonary Medicine Service at an academic medical center in the U.S. from 1/1/11 to 12/31/11. A total of 69 charts were audited.
  
  
  METHODS
  Outcome measures included time to initiation of feeds, prescribed versus received protein and energy on day three, prokinetic use and markers of nutritional status.
  
  
  RESULTS
  Delayed time to feeding, greater than 48hours after ICU admission, was present in 66.7% of the sample. On day three only 9% of the sample was receiving 80% or more of the prescribed protein or energy. These findings are similar to those found internationally.
  
  
  CONCLUSIONS
  Critically ill patients continue to experience delays in enteral feeding initiation and are frequently not meeting nutrition targets. Interventions aimed at improving nutrition delivery in the intensive care unit should be a focus of quality care both in the U.S. and internationally.
authors.affiliation: University of Kentucky Medical Center, 800 Rose Street, Lexington, KY 40536, USA. Electronic address: mdlott0@uky.edu.
authors.forename: Melissa Lottes
authors.initials: ML
authors.lastname: Stewart
authors.affiliation: 525 College of Nursing, University of Kentucky, Lexington, KY 40536, USA. Electronic address: mjbidd0@uky.edu.
authors.forename: Martha
authors.initials: M
authors.lastname: Biddle
authors.affiliation: University of Kentucky, Department of Clinical Sciences, College of Health Sciences, 209H CTW Building, 900 South Limestone, Lexington, KY 40536, USA. Electronic address: dth225@uky.edu.
authors.forename: Travis
authors.initials: T
authors.lastname: Thomas
mesh_terms: D000328:Adult; D000368:Aged; D016638:Critical Illness / Q000451:nursing*; D004750:Enteral Nutrition / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000187:drug effects*; D012189:Retrospective Studies; D013997:Time Factors
keywords: Adult; Critical care; Critical illness; Enteral nutrition; Malnutrition; Retrospective studies