Development of evidence-based guidelines and critical care nurses ' knowledge of enteral feeding.

Enteral nutrition in critically ill patients has been widely debated. Some of the questions include optimal time to begin enteral feeding, gastric versus small-bowel tube placement, and what markers should be used to measure intolerance to enteral nutrition. Although some of these questions are yet to be answered, more evidence has become available since the 1990s to guide practice. For critically ill patients who cannot consume an oral diet, enteral nutrition is recommended rather than parenteral nutrition because the incidence of infectious complications and costs are lower with enteral nutrition. Enteral feeding should be started within the first 24 to 48 hours of admission in