Enteral Nutrition Management and Nursing Practices in Intensive Care Units

Öz

Nutritional support is one of the main components of the treatment process in intensive care patients. Enteral nutrition is a physiologically and safely preferred method in cases where the gastrointestinal tract is functional. This review study aims to examine the clinical importance of enteral nutrition in intensive care patients, its physiological foundations and nursing practice standards in the light of literature. The effectiveness of enteral nutrition, the management of complications and the difficulties faced by nurses have been discussed extensively. In addition, nurses educational needs of nurses and the importance of using up-to-date clinical guidelines were emphasized. As a result, it is stated that in order for enteral nutrition to be successfully applied, nurses' knowledge levels should be increased and access to guidelines and application standards should be improved. In this direction, the importance of institutional support and continuing education programs is emphasized.

Anahtar Kelimeler

• : Complication management
• Enteral nutrition
• Intensive care
• Nursing practices.

Yoğun Bakım Ünitelerinde Enteral Beslenme Yönetimi ve Hemşirelik Uygulamaları

Öz

Yoğun bakım hastalarında beslenme desteği, tedavi sürecinin temel bileşenlerinden biridir. Enteral beslenme, gastrointestinal sistemin işlevsel olduğu durumlarda tercih edilen fizyolojik ve güvenli bir yöntemdir. Bu derleme çalışması, yoğun bakım hastalarında enteral beslenmenin klinik önemini, fizyolojik temellerini ve hemşirelik uygulama standartlarını literatür ışığında incelemeyi amaçlamaktadır. Enteral beslenmenin etkinliği, komplikasyonların yönetimi ve hemşirelerin karşılaştığı güçlükler kapsamlı olarak ele alınmıştır. Ayrıca, hemşirelerin eğitim ihtiyaçları ve güncel klinik rehber kullanımının önemi vurgulanmıştır. Sonuç olarak, enteral beslenmenin başarıyla uygulanabilmesi için hemşirelerin bilgi düzeylerinin artırılması, rehberlere erişim ve uygulama standartlarının geliştirilmesi gerektiği belirtilmektedir. Bu doğrultuda, kurumsal destek ve sürekli eğitim programlarının önemi ortaya konmaktadır.

Anahtar Kelimeler

• : Enteral beslenme
• Hemşirelik uygulamaları
• Komplikasyon yönetimi
• Yoğun bakım

Kaynakça

1. 1. Martínez-Olmos MA, Martínez-Vázquez MJ, Martínez-Puga López E, del Campo Pérez V. Nutritional status study of inpatients in hospitals of Galicia. Eur J Clin Nutr. 2005;59:938–946.
2. 2. Waitzberg DL, Correia MI. Nutritional assessment in the hospitalized patient. Curr Opin Clin Nutr Metab Care. 2003;6:531–538.
3. 3. Btaiche IF, Chan LN, Pleva M, Kraft MD. Critical illness, gastrointestinal complications, and medication therapy during enteral feeding in critically ill adult patients. Nutr Clin Pract. 2010;25:32–49.
4. 4. Bourgault AM, Ipe L, Weaver J, Swartz S, O’Dea PJ. Development of evidence-based guidelines and critical care nurses’ knowledge of enteral feeding. Crit Care Nurse. 2007;27(4):17–29.
5. 5. Williams TA, Leslie GD. A review of the nursing care of enteral feeding tubes in critically ill adults: part II. Intensive Crit Care Nurs. 2005;21(1):5–15.
6. 6. Kozeniecki M, Fritzshall R. Enteral nutrition for adults in the hospital setting. Nutr Clin Pract. 2015;30(5):634–651.
7. 7. Sobotka L. Diagnosis of malnutrition. In: Allison SP, ed. Basics in Clinical Nutrition. 4th ed. Prague: Galen Press; 2011:269–271.
8. 8. Lasierra JLF, Pérez-Vela JL, González JCM. Enteral nutrition in the hemodynamically unstable critically ill patient. Med Intensiva. 2015;39(1):40–48.

9. 9. McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). J Parenter Enteral Nutr. 2016;40(2):159–211.
10. 10. Murray K, Mehta S. Home parenteral nutrition for patients with intestinal failure due to advanced cancer. Br J Nurs. 2018;27(Suppl 4a):S1–S8.
11. 11. Stewart ML. Nutrition support protocols and their influence on the delivery of enteral nutrition: A systematic review. Worldviews Evid Based Nurs. 2014;11(3):194–199.
12. 12. Anthony PS. Nutrition screening tools for hospitalized patients. Nutr Clin Pract. 2008; 23:373–382.
13. 13. Gürkan A, Bilgi G. Enteral beslenme: bakımda güncel yaklaşımlar. Anadolu Hemşire Sağlık Bilim Derg. 2013;16(2):116–122.
14. 14. Cederholm T, Jensen GL, Correia MITD, et al. GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community. Clin Nutr. 2019;38(1):1–9.
15. 15. Stroud M, Duncan H, Nightingale K. Guidelines for enteral feeding in adult hospital patients. Gut. 2003;52(Suppl VII):vii1–vii12.
16. 16. Pancorbo-Hidalgo PL, Garcia-Fernandez FP, Ramirez-Perez C. Complications associated with enteral nutrition by nasogastric tube in an internal medicine unit. J Clin Nurs. 2001;10(4):482–490.
17. 17. Gavi S, Hensley J, Cerva F, Nicastri C, Fields S. Management of feeding tube complications in the long-term care resident. Ann Longterm Care. 2008;16(4):28–32.
18. 18. Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clinical Nutrition. 2019;38(1):48-79.
19. 19. Heyland DK, Cahill NE, Dhaliwal R, Sun X, Day AG, McClave SA. Impact of enteral feeding protocols on enteral nutrition delivery: results of a multicenter observational study. J Parenter Enteral Nutr. 2010;34(6):675–684.
20. 20. Ahmed A, Anteneh S, Hussien A, Seid A, Semanew Y. Enteral tube feeding practices and associated factors among nurses working in South Wollo Zone Specialized and General Hospitals, Wollo, Ethiopia, 2022. Front Nutr. 2024;11:1399651.
21. 21. Nguyen DL. Guidance for supplemental enteral nutrition across patient populations. Am J Manag Care. 2017;23(12):210–219.
22. 22. Al-Sayaghi KM, Saad Alqalah TAH, Alkubati SA, et al. Critical Care Nurses' Perceptions of Enteral Nutrition. Open Nurs J. 2022;16:1180.
23. 23. Winkelman C, Best K. Formula for success: deliver enteral nutrition using best practices. Am Nurs Today. 2009;4(3):18–23.