Nutrition in the Intubated Patient

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Recommended: Evidence based practice research assignment

When performing evidence based practice research, the Iowa Model uses a team or individual approach to assist nurses in the journey to quality care. The Iowa Model begins by offering a process of selecting a proper clinical topic, which is often a recurring problematic issue (Polit & Beck, 2012). This topic is formulated as a question to improve a technique or procedure. Once the researcher determines that an ample amount of reported investigation exists on the desired question, information may be gathered and presented for approval (Polit & Beck, 2012). The research may lead to a gradual change in nursing practice.
PICO
In the critical care population, patients on ventilator support require nutritional supplementation. To support the metabolic processes, healthcare providers address the initiation of feedings within the plan of care (Khalid, Doshi, & DiGiovine, 2010). For therapeutic nutritional support, providers compare the risks and benefits of enteral and parenteral feedings. Following intubation, one goal is to initiate feedings within 24 to 48 hours, to provide optimal patient outcomes, and decrease the risk of ventilator-acquired pneumonia (Ridley, Dietet, & Davies, 2011).
PICO Question
Are intubated patients placed at a greater chance of infection based on the initiation of parenteral verses enteral nutritional support?
Literature Review
The Cumulative Index to Nursing and Allied Health Literature (CINAHL) was used to find peer-reviewed articles, using query terms such as: aspiration pneumonia, ventilator, and prevention. In addition, the TWUniversal search engine was utilized to find peer-reviewed articles, with the key words: aspiration pneumonia, ventilator, and enteral.
In a, Level III hierarchy, sy...

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Khalid, I., Doshi, P., & DiGiovine, B. (2010). Early enteral nutrition and outcomes of critically ill patients treated with vasopressors and mechanical ventilation. American Journal of Critical Care, 19(3), 261-268. doi:10.4037/ajcc2010197
Polit, D. F. & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice (9th ed.). Philadelphia: Lippincott.
Ridley, E. J., Dietet, B. N., & Davies, A. R. (2011). Practicalities of nutrition support in the intensive care unit: the usefulness of gastric residual volume and prokinetic agents with enteral nutrition. Nutrition, 27(5), 509-512. doi:10.1016/j.nut.2010.10.010
Seron-Arbeloa, C., Zamora-Elson, M., Labarta-Monzon, L., & Mallor-Bonet, T. (2013). Enteral nutrition in critical care. Journal of Clinical Medicine Research, 5(1), 1-11. doi:10.4021/jocmr1210w

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