Clinical Nutrition Nursing Guideline for Critical Patients with Ventilator

Chiang, Lin-Ying

Purpose:

The rate of successful weaning ventilator is strongly related to the nutritional status of patients. It is necessary to establish the clinical nutrition nursing guideline for critical patients with ventilator. However, nutrition care guidelines in respirator patients are not well established in Taiwan. The aim of the study was to develop clinical nutrition nursing care guidelines according to evidence-based medicine.

Methods:

There were three stages in the study. First stage, we implemented a systematic review in 10 databases and 13 websites to search relevant literatures of clinical guidelines from 2001 to 2013. Eleven studies met our inclusion criteria. There were 7 RCT studies and 4 clinical guidelines. These studies were used to establish a draft with 45 items. Second stage, we held focus group meetings through inviting 10 experts with good nursing experience in respiratory care and two nutritionists to further modify clinical nutrition care guidelines for patients with ventilators. Third stage, we conducted a questionnaire survey to evaluate the feasibility of the nutrition nursing guideline for critical patients with ventilator. At this stage, we invited 210 clinical nurses with at least 2 years working experience in the intensive care unit of the medical center.

Results:

The original 45 items of the draft were reduced to 34 items, including 6 nutritional nursing assessment; 18 nutritional nursing intervention; 5 nutritional nursing evaluation and 5 complication care. The average of overall agreement was 98.8%. The scores were 33 Grade A and 1 Grade B.

Conclusion:

The result suggested that nurses' nutritional assessment capability and sensitivity can be improved by in-service education. It was included four major objects of the nurtrition, there are nursing assessments, nursing interventions, nursing evaluation and complications nursing care. The skills of nutritional care measures are strengthened for further helping patients to achieve in ventilator weaning and enhance the quality of care.