Effects on nutritional care practice after implementation of a flow chart‐based nutrition support protocol in an intensive care unit

BACKGROUND Enteral nutrition (EN) is associated with improved outcome in critically ill patients and is more affordable. We compared nutritional care practice in our ICU before and after modification of our nutrition support protocol: Several comprehensive documents were substituted with one flow chart and early EN was encouraged. DESIGN Retrospective observational study. METHODS Nutritional data were collected from admission up to 7 days in 25 patients before and 25 patients after protocol modification. RESULTS The percentage of patients receiving EN within 72 hr of admission increased from 64% before to 88% after protocol modification. Cumulative percentage energy from EN during ICU days 1-4 increased from 26-89% of total kcal. Overall amount of nutrition administered enterally increased, with a corresponding marked decline in use of parenteral nutrition. Pre-modification, >80% of patients received >65% of their calculated nutrition requirements by ICU Day 4; post-modification this goal was achieved by Day 7.