Construction and clinical practice of an enteral nutrition nursing quality control system for critically ill patients

Am J Transl Res. 2022 Dec 15;14(12):9031-9039. eCollection 2022.

Abstract

Critically ill patients are prone to a series of complications during early enteral nutrition (EEN), including gastrointestinal complications, infectious complications, metabolic complications, and mechanical complications, with an incidence of 30.5-65.7%, which attributes to prolonged hospitalization and increased mortality. Therefore, this retrospective study aimed to construct a quality control system of enteral nutrition nursing for critically ill patients as well as apply this system in clinical practice to evaluate its effect. Delphi method was utilized for this purpose, and we compared the incidence of enteral nutrition complications between patients using quality control system and using routine enteral nutrition. The mastery of enteral nutrition related knowledge by nursing staff was also compared before and after the implementation of a quality control system. Our data showed that, after applying the system to patients with critical illness in the nursing clinic, the incidence of enteral nutrition gastrointestinal complications, infectious complications, metabolic complications, and mechanical complications was significantly decreased from 11.51%, 1.96%, 3.41% and 5.88% to 1.86%, 0.52%, 1.71% and 0.97% (P<0.005), respectively. Furthermore, the awareness of enteral nutrition theory by ICU nurses was also significantly improved, and the questionnaire score was increased from 70.22±8.78 to 95.25±4.18 (t=18.792, P<0.001). Hence, the enteral nutrition nursing quality control system we developed could effectively guide nursing staff to implement enteral nutrition, reduce the occurrence of enteral nutrition complications in patients with critical illness and ensure the safety of patients, suggesting the clinical application value of our system.

Keywords: Enteral nutrition; intensive care; quality control; quality of care; tolerance.