Date of Award

Fall 11-17-2018

Document Type

Thesis

Degree Name

Master of Science (MS)

Department

Human Ecology

First Advisor

Janet Pope

Abstract

The rate based system for delivering enteral nutrition has been found to result in an average delivery of 60-65% of estimated energy and protein needs in ICU patients. Interruptions in tube feedings for surgery, intolerances, and turning/bathing cause underfeeding as the rate based system does not allow the rate to be adjusted for any lost volume. At Northwest Hospital, protocol is to calculate the hourly tube feeding rate over 20 hours, and run over 24 hours, in order to adjust for an expected 4 hours of interruptions per day; however, the effectiveness of this protocol has not been studied. The purpose of this study was to determine the adequacy of this protocol in delivering >80% of the prescribed energy and protein needs, as recommended by ASPEN, in order to determine if a volume based protocol, in which the hourly rate can be adjusted to make up for lost volume of tube feeding, may be more sufficient. This study was a prospective observational study involving 50 ICU patients on tube feeding for at least 24 hours. Kangaroo pumps were checked for all patients on tube feeding at 0700 each morning. Analysis was conducted using the SPSS software one sample t-test. Average tube feeding delivered (71.1±28.3) was less than the accepted average of 80%, a statistically significant difference of 8.9 (95% CI, 0.84 to 16.92; t(49) = -2.22, p= 0.031). Surgeries and high gastric residual volume were found to be the most common reasons for tube feeding interruptions.

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