A new nutrition bundle strives to ensure that critically ill patients receive adequate nutrition while hospitalized and seeks to reduce adverse outcomes related to malnutrition.
More than half of patients admitted to critical care units are malnourished, which increases their risk for serious complications and contributes to longer hospital stays and higher healthcare costs. Yet many of those eligible to receive enteral feedings do not receive adequate nutrition while hospitalized.
The American Society of Parenteral and Enteral Nutrition (ASPEN), in conjunction with the Society of Critical Care Medicine, created the nutrition bundle to ensure that patients' nutrition status is optimized during acute care stays. The bundle is part of ASPEN's updated guidelines for the assessment and implementation of nutrition support in patients who are critically ill.
"New Nutrition Guidelines: Promoting Enteral Nutrition via a Nutrition Bundle", in the June 2018 issue of Critical Care Nurse (CCN), addresses all components of nutrition, including assessment and interventions.
Ashleigh VanBlarcom, DNP, RN, AGACNP-BC, and Mary Anne McCoy, PhD, RN, ACNP-BC, wrote the article while VanBlarcom was earning a DNP degree at Wayne State University College of Nursing, Detroit, where McCoy is specialty coordinator of the DNP AGACNP and the AGACNP graduate certificate specialties. VanBlarcom is now an acute care nurse practitioner in the thoracic-cardiovascular intensive care unit at the University of Virginia Health System, Charlottesville.
"Malnutrition in hospitals is often overlooked, underdiagnosed and untreated," VanBlarcom said. "The ASPEN nutrition bundle offers bedside nurses, registered dietitians, providers and other members of the interprofessional team a comprehensive, step-by-step approach to early nutrition."
The six main components of the nutrition bundle are as follows:
- Assess patients' nutrition status to identify those at risk for malnutrition.
- Initiate and maintain enteral nutrition.
- Reduce risks for aspiration.
- Implement enteral feeding protocols.
- Avoid the use of gastric residual volumes as an assessment of enteral feeding tolerance.
- Consider parenteral nutrition early, when enteral feedings cannot be initiated.
Together, the components address the distinct aspects of nutrition assessment and related interventions for critically ill patients. As a result, patients can receive adequate nutrition earlier in their hospital stay, which may reduce their risk of adverse outcomes.
As the American Association of Critical-Care Nurses' bimonthly clinical practice journal for high-acuity, progressive and critical care nurses, CCN is a trusted source of information related to the bedside care of critically and acutely ill patients.