Semester

Summer

Date of Graduation

2025

Document Type

Dissertation

Degree Type

DNP

College

School of Nursing

Department

Anesthesiology

Committee Chair

Rebecca Smeltzer

Committee Co-Chair

Aaron Ostrowski

Committee Member

Sandy Gray

Committee Member

Gina Carenbauer

Committee Member

Karen Lutomski

Committee Member

Alexandra Haydu

Abstract

Abstract

Implementation of an Evidenced Based Enteral Nutrition Protocol for Mechanically Ventilated Patients: A Quality Improvement Initiative.

Hannah Nuzum

Background: Mechanically ventilated patients require supplemental nutrition as an important factor for their overall recovery. Malnutrition in hospitalized patients is reported as high as 35% (Ikram et al., 2022).

Purpose: Lack of an enteral nutrition (EN) protocol has contributed to variability in initiation of EN for post-intubated mechanically ventilated patients.

Intervention: The project interventions are threefold: the development of an EN protocol, EN initiated within 24 to 28 hours for post-intubation patients, and staff understands that EN should be initiated within 24 to 48 hours after post-intubation for better patient outcomes.

Methods: This change project was developed utilizing the Lewin’s Theory of Change theoretical framework to implement an EN protocol for adult intensive care unit patients. Collaboration with the information technology team will be done to integrate clinical notifications within the electronic health record, and education will be provided to staff to appropriately implement the enteral nutrition protocol into patient care. Staff will also take post intervention surveys to look at potential barriers and feasibility of the intervention.

Results: EN protocol was developed and integrated within the medical intensive care unit at Ruby Memorial Hospital. The median time for initiation of EN for pre-intervention patients was 79 hours, and the median time for initiation of EN for post-intervention patients was 17 hours.

Conclusions: Development of an electronic EN protocol aids in making initiation of EN for mechanically ventilated patients more consistent and improves the time to initiation of EN for critically ill patients.

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