Complexities of Nutritional Management and its Relationship to Clinical Outcomes in Chronically Critically Ill Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/160355
Type:
Presentation
Title:
Complexities of Nutritional Management and its Relationship to Clinical Outcomes in Chronically Critically Ill Patients
Abstract:
Complexities of Nutritional Management and its Relationship to Clinical Outcomes in Chronically Critically Ill Patients
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2005
Author:Higgins, Patricia, PhD, MSN, BSN
P.I. Institution Name:Case Western Reserve University
Title:Assistant Professor
Contact Address:School of Nursing, 10900 Euclid Avenue, Cleveland, OH, 44106-4904, USA
Contact Telephone:216-368-8850
Co-Authors:Amy R. Lipson, PhD, Project Director and Su-Er Guo, MSN, Graduate Research Assistant
Significance: Although severity of illness is the single most
important predictor of survival in critically ill patients, there are many
questions about the contribution of other factors to patient outcomes. The
purpose of this paper is to describe calorie intake variations in
chronically critically ill (CCI) patients and its relationship to
nutritional and clinical outcomes.
Methods: A prospective, longitudinal design was used to abstract data from
the patient records of 400 adult patients who required >72 hours of
long-term ventilation (LTV). Weekly data were collected while the subjects
were hospitalized, for a total of 756 feeding days. Nutritional data
reported are body mass index (BMI), serum albumin, prealbumin, hemoglobin,
dieticians' recommendations, physicians' orders, and patients' actual
24-hour caloric intake. Patient outcome data are survival status and
length of time on mechanical ventilation.
Results: Inconsistencies among dieticiansÆ recommendations, physicians'
orders and nurses' implementation resulted in wide variations in subjects'
calculated nutritional adequacy. Subjects received an average of 83% of
the Kilocalories (Kcals) ordered by their physicians (SD=27%,
range=0-200%) and 68% of the dieticiansÆ recommended Kcals (SD=33%,
range=0-219%). For subjects who died (N=155), there were no statistically
significant relationships between nutrition variables and length of
mechanical ventilation. For survivors, BMI and three laboratory values
(admission serum albumin and mean albumin and hemoglobin during
hospitalization) explained 12% of variation in time on mechanical
ventilation.
Conclusions: Multiple factors influence supplemental feeding practices in
CCI patients. These practices result in both under and over-prescribing
and under and over-feeding. Nurses need better information about
organizational factors that affect nutrition management as well as the
impact of nutritional adequacy on outcomes related to mechanical
ventilation and discharge disposition. This study is supported by
NINR05005.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleComplexities of Nutritional Management and its Relationship to Clinical Outcomes in Chronically Critically Ill Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160355-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Complexities of Nutritional Management and its Relationship to Clinical Outcomes in Chronically Critically Ill Patients</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Higgins, Patricia, PhD, MSN, BSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Case Western Reserve University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">School of Nursing, 10900 Euclid Avenue, Cleveland, OH, 44106-4904, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">216-368-8850</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">pxg3@po.cwru.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Amy R. Lipson, PhD, Project Director and Su-Er Guo, MSN, Graduate Research Assistant</td></tr><tr><td colspan="2" class="item-abstract">Significance: Although severity of illness is the single most <br/> important predictor of survival in critically ill patients, there are many <br/> questions about the contribution of other factors to patient outcomes. The <br/> purpose of this paper is to describe calorie intake variations in <br/> chronically critically ill (CCI) patients and its relationship to <br/> nutritional and clinical outcomes. <br/> Methods: A prospective, longitudinal design was used to abstract data from <br/> the patient records of 400 adult patients who required &gt;72 hours of <br/> long-term ventilation (LTV). Weekly data were collected while the subjects <br/> were hospitalized, for a total of 756 feeding days. Nutritional data <br/> reported are body mass index (BMI), serum albumin, prealbumin, hemoglobin, <br/> dieticians' recommendations, physicians' orders, and patients' actual <br/> 24-hour caloric intake. Patient outcome data are survival status and <br/> length of time on mechanical ventilation.<br/> Results: Inconsistencies among dieticians&AElig; recommendations, physicians'<br/> orders and nurses' implementation resulted in wide variations in subjects' <br/> calculated nutritional adequacy. Subjects received an average of 83% of <br/> the Kilocalories (Kcals) ordered by their physicians (SD=27%, <br/> range=0-200%) and 68% of the dieticians&AElig; recommended Kcals (SD=33%, <br/> range=0-219%). For subjects who died (N=155), there were no statistically <br/> significant relationships between nutrition variables and length of <br/> mechanical ventilation. For survivors, BMI and three laboratory values <br/> (admission serum albumin and mean albumin and hemoglobin during <br/> hospitalization) explained 12% of variation in time on mechanical <br/> ventilation.<br/> Conclusions: Multiple factors influence supplemental feeding practices in <br/> CCI patients. These practices result in both under and over-prescribing <br/> and under and over-feeding. Nurses need better information about <br/> organizational factors that affect nutrition management as well as the <br/> impact of nutritional adequacy on outcomes related to mechanical <br/> ventilation and discharge disposition. This study is supported by <br/> NINR05005.</td></tr></table>en_GB
dc.date.available2011-10-26T22:51:52Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T22:51:52Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.