title: Enteral nutrition administration in a surgical intensive care unit: Achieving goals with better strategies.
abstract: OBJECTIVE
  To evaluate the impact of an enteral feeding protocol on administration of nutrition to surgical intensive care unit (SICU) patients.
  
  
  METHODS
  A retrospective chart review was conducted on patients initiated on enteral nutrition (EN) support during their stay in a 14 bed SICU. Data collected over a seven-day period included date of tube feed initiation, rate initiated, subsequent hourly rates, volume provided daily, and the nature and length of interruptions. The six months prior to implementation of the feeding protocol (pre-intervention) and six months after implementation (post-intervention) were compared. One hundred and four patients met criteria for inclusion; 53 were pre-intervention and 51 post-intervention.
  
  
  RESULTS
  Of the 624 patients who received nutrition support during the review period, 104 met the criteria for inclusion in the study. Of the 104 patients who met criteria outlined for inclusion, 64 reached the calculated goal rate (pre = 28 and post = 36). The median time to achieve the goal rate was significantly shorter in the post-intervention phase (3 d vs 6 d; P = 0.01). The time to achieve the total recommended daily volume showed a non-significant decline in the post-intervention phase (P = 0.24) and the overall volume administered daily was higher in the post-intervention phase (61.6% vs 53.5%; P = 0.07). While the overall interruptions data did not reach statistical significance, undocumented interruptions (interruptions for unknown reasons) were lower in the post-intervention phase (pre = 23/124, post = 9/96; P = 0.06).
  
  
  CONCLUSIONS
  A protocol delineating the initiation and advancement of EN support coupled with ongoing education can improve administration of nutrition to SICU patients.
authors.affiliation: Sara Wilson, Department of Clinical Nutrition, Mount Sinai Hospital, New York, NY 10129, United States.
authors.forename: Sara
authors.initials: S
authors.lastname: Wilson
authors.affiliation: Sara Wilson, Department of Clinical Nutrition, Mount Sinai Hospital, New York, NY 10129, United States.
authors.forename: Nagendra Y
authors.initials: NY
authors.lastname: Madisi
authors.affiliation: Sara Wilson, Department of Clinical Nutrition, Mount Sinai Hospital, New York, NY 10129, United States.
authors.forename: Adel
authors.initials: A
authors.lastname: Bassily-Marcus
authors.affiliation: Sara Wilson, Department of Clinical Nutrition, Mount Sinai Hospital, New York, NY 10129, United States.
authors.forename: Anthony
authors.initials: A
authors.lastname: Manasia
authors.affiliation: Sara Wilson, Department of Clinical Nutrition, Mount Sinai Hospital, New York, NY 10129, United States.
authors.forename: John
authors.initials: J
authors.lastname: Oropello
authors.affiliation: Sara Wilson, Department of Clinical Nutrition, Mount Sinai Hospital, New York, NY 10129, United States.
authors.forename: Roopa
authors.initials: R
authors.lastname: Kohli-Seth
keywords: Critical care; Enteral nutrition; Nutrition support; Protocol; Surgical critical care