Enteral Nutrition Practices and Procedures - Essay Example

A European survey of enteral nutrition practices and procedures in adult intensive care units Introduction Fulbrook, Bongers, and Albarran (2007) performed a survey study regarding enteral nutrition practices in adults’ intensive care units. Enteral nutrition is essential for patients who are nil per oral and at risk of nutritional deficiencies (Harrington, 76). Timely enteral nutrition administration reduces the risk of complications and boosts the recovery rate for patients in this feeding mode. However, despite having the knowledge of the importance of timely administration of enteral feeding, in most ICUs this practice is overlooked (Fulbrook et al., p. 157). Article Critique Problem and Purpose The purpose of this study was to determine the practices of enteral nutrition and procedures among adults in intensive care units (Fulbrook et al., p. 163). The independent variables were adults in intensive care units while the dependent variables were practices of enteral feeding. A hypothesis of this study was that timely administration of enteral feeding could minimize complications in the ICU and improve the recovery rates among adult patients in ICU. (Fulbrook et al.,p. 166). A progression of worldwide studies has demonstrated that, in numerous ICUs, health care providers do not begin enteral nutrition for all qualified patients. Postponing timing in the organization, and a few highlights having an effect on a conveyance may lead to disappointment in individual encouraging targets (Fulbrook et al., p. 174). Review of literature This article focuses on a literature review with the aim of helping establish the criterion for enteral nutrition among the critically ill as well as helping identify timely initiation among those eligible. Proper assessments are essential before initiating this mode of feeding. (Fulbrook et al.,p. 178). Enteral feeding is a necessity to optimize caloric targets. The research suggests that enteral nutrition to commence within 24-48 hours and the nurse should monitor the patient for any complications arising from this feeding method. The reported troubles in improving calorific admission in critically ill patients have driven the ICU group to distinguish proof based rules to create models of NS and enhance persistent results. (Fulbrook et al.,p. 176). Early start of EN, the lower term of mechanical ventilation, decrease in the unseemly utilization of parenteral sustenance (PN), potential to decrease sepsis-related complexities, intrusions in conveyance and diminished danger of death. Sample A convenience sample test of basic consideration of medical caretakers speaking to 20 nations of the European federation of Critical Care Nursing associations (EfCCNa) was welcome to take part in the study. Each partaking ICU got one self-administered questionnaire for fulfillment. A sum of 383 review surveys is the subjects in the study. The research employed a survey design. A combination of issues, which is an essential feature in a study, was used (David & Sutton , 123). The questionnaire did not require the responders to specify which health care profession is responsible for nutritional assessments in ICU. However, an experimental design would have been appropriate for this study since the outcome of enteral nutrition is essential. Legal and ethical issues EfCCNa council ensured permission to carry out the study. All respondents filled a consent form allowing the researchers to use them as subjects in their study. The researchers guaranteed the respondents that all data would remain confidential (Fulbrook et al., p. 175-180). Response to the questionnaires proved productive by the respondents will return a completed questionnaire. However, an ethics committee to ensure the researcher adhered to the set ethics was not involved in the study. Internal and external validity The questionnaire took into account proof from the researchers, clinical experience variables that could add to the unwavering quality of a review (Fulbrook et al., p. 182). Enrolled interpreters arranged the surveys in 14 dialects. EfCCNa agents then checked on the pole for issues of etymological precision, clarity of specialized wording, inside consistency and substance legitimacy. Specialists in the medical field familiar with the 14 languages were the subjects. The researchers did not conduct a pilot study, a gross mistake. Data Senior medical attendants from partaking units got the survey with a covering letter, on headed paper, exhibited in their particular dialect, which sketched out the reason for the study and that support was willful. Such measures help to console respondents about the honesty of the association involved. The researchers used six months to gather the data. They also employed the use of non-parametric tests to examine the relationship involved. Where variables were unmitigated or ordinal, a non-parametric test carried out to inspect distinction. Yates adjustment made for 2-2 tables. Spearmans Rank Request Correlation utilized to compute the connection coefficient and criticalness of ordinal variables. Investigation of fluctuation (ANOVA) examined contrasts between multi-factorial variables. Since the outcomes remain may not vary, rehearse, criticalness should situated. Conclusions, implications and recommendations In general, there are a few likenesses and contrasts in wholesome practices and methods between European adults ICU. In a few regions, the practice was steady, for instance, in the across the board, reception of NG tubes as the favored supported course. In the expanded utilization of wholesome conventions, which are supported by global rules (Fulbrook et al., p. 196). There are likewise some critical issues, which warrant further consideration. These identify with the constrained Association of ICU nurses performing wholesome appraisals, creating confirmation built clinical conventions in light of supporting and reconsidering their rules for NGT arrangement. It may presume that the hidden issue identifies with the absence of expertise, assets, and time. Getting the best accessible confirmation to illuminate professional confidence, build the certainty of nurses in creating clinical conventions to advance consideration. Joint effort in creating intra-proficient European rules on EN is one arrangement to enhancing benchmarks. Medical caretaker training projects can have an impact as well, in supporting clinical practice, by setting strong emphasis on hypothetical ideas, expertise advancement. Furthermore, the utilization of discriminating evaluation abilities. Nurses assume a vital part in the wholesome management of critically ill patients, especially because they are most typically in charge of guaranteeing the patient gets their recommended sustenance. In this study, doctors were in charge of wholesome evaluation. In any case, the health care providers working in ICU should conduct nonstop checking of nutritional status with standard modification as indicated by changes in the tolerance status. In this connection, the ceaseless evaluation of the tolerance dietary status (and their reaction to medications and medications) is an exceedingly significant component of the ICU medical caretakers continuous obligation. Evaluation of a sick patient wholesome status and prerequisites can be extremely unpredictable, and the part of the dietician is likewise pivotal. As specialists around there, they are a significant asset to the ICU group and preferably will be included effectively being taken care of by all patients. Likewise, with numerous different measurements of serious consideration, the wholesome administration is a multi-proficient obligation, which obliges a coordinated group approach. In this manner, safe also, powerful practice requires the community-oriented endeavors of all individuals from the group. The researchers suggest that the advancement of strategies, methods and clinical rules and instructive projects ought to be between expert. Experts should learn with, from and about one another to encourage coordinated effort and administration change (Fulbrook et al., p. 203). Modern nurses need to have basic knowlegde on the need of enteral nutrition. The type of knowledge required includes proper insertion of the feeding tubes, observing aseptic technique in performing the procedure, asking for the patient consent, determing the patient’s level of criticallness and the type of feed to use in that particular patient. Health care institutions should be able to take records on the available patients in the ward who are critically ill and require enteral form of nutrition because it assists during emergency care for example, taking care of patients that require urgent feeding, cardiopulmonary resuscitation, changing already used feeds and prescribing new feeds. It is recommended that nurses work under critical unit to undergo further learning to get new information concerning the management of patients with enteral feeding. Another recommendation is to observe the nursing manual procedure on fitting the feeding tubes to patients to avoid infections that can be acquired through sepsis. Application to nursing practice With an increasing number of patients’ admissions in ICU, there is a growing need for providing quality care to the patients. Timely assessments need to ensure enteral nutrition therapy commence in time. There are, however, constrained resources and future advancements are key to providing quality care. Enteral nutrition guidelines are essential in developing a criterion for which enteral nutrition is appropriate. Decisions on healthcare provision to patients requiring this mode of feeding rely on the observed outcomes. This research can also provide a firm basis upon which medical practitioners can understand the reason for using enteral nutrition on certain patients, the assessment of certain levels of nutrition in these patients and lastly the management of patients under enteral nutrition to decrease chances of patients acquiring infections through feeding tubes. This research creates an opportunity for nurses to evaluate other methods of enteral feeding. By determining their advantages and disadvantages. It is through this that nurses are able to broaden their knowledge in this field and come up with other related research projects that can assist enteral nutrition. The result of this research can provide statistics in the recent world which helps medical practitioners to be able to choose the correct form of feeding. It also acts as a source of information to people who have relatives feeding through tubes and patients themselves as they are able to understand the reason for using a certain route for feeding and rejecting the other. Guidelines for the comprehensive improvement of caloric intake through enteral nutrition ensures a specified course of aiding the recovery of patients in ICU. Where rules are promptly accessible, their importance for nursing practice may be insignificant. Hence, numerous parts of enteral nutrition for which medical attendants are dependable, have deficient proof to empower substantial proposals or are primarily not specified in the rules. References David, M., & Sutton, C. (2004). Social Research. London: Sage Publications. Fulbrook, P., Bongers, A., & Albarran, W. (2007). A European Survey of Enteral Nutrition Practices and Procedures in Adult Intensive Care Units. Journal of Clinical Nursing, 2132-2141. Harrington, L. (2004). Nutrition in Critically Ill Adults: key processes. Critical Care Nursing Clinics of North America, 459-465. Read More