Ward-based nutrition care practices and a snapshot of patient care: Results from nutritionDay in the ICU

Joshua Pearcy*, Ekta Agarwal, Elizabeth Isenring, Ananya Somani, Charlene Wright, Bhuvaneshwari Shankar

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: 

Poor adherence to intensive care unit (ICU) guidelines is common, leading to suboptimal nutritional care. This study determined current ward-based nutrition care practices in the Indian ICU setting, comparing them to international best-practice guidelines and provided patient demographic, clinical and nutritional information to serve as baseline data for future benchmarking. 

Methods

This multi-site cross-sectional retrospective study analysed data collected from nutritionDay worldwide audits (2012–2016) across ICUs from a chain of urban private hospitals in India. Additional guideline-specific data were collected through questionnaires and phone interviews with the Head of Dietetics Departments in the participating hospitals. 

Results: 

Overall, 10 ICUs and 457 participants were included. It was common practice to use modified versions of the Mini Nutritional Assessment-Short Form (MNA-SF) and Subjective Global Assessment (SGA) for nutrition screening and assessment. Nearly half the participants (n = 222, 49%) received nutrition orally. A majority of the remaining participants received enteral nutrition (n = 163, 36%) or no nutrition (n = 60, 13%) at the time of data collection. The calories prescribed for most participants were between 1500 and 1999 kilocalories per day (n = 207, 45%), with no nutrition planned for 115 (25%) participants. Three-quarters (n = 129, 74%) of participants on EN received the planned calories, while 24% (n = 42) were given less than planned. 

Conclusion:

Overall, most participants received the calories planned for enteral nutrition. The use of modified screening and assessment tools and suboptimal delivery of EN remains a global problem for critical care, possibly requiring a more pragmatic approach to nutritional therapy.

Original languageEnglish
Pages (from-to)340-345
Number of pages6
JournalClinical Nutrition ESPEN
Volume41
Early online date17 Nov 2020
DOIs
Publication statusPublished - Feb 2021

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