Background

Nutritional status has profound effects on metabolic response to injury and can impact significantly on patient outcome in the paediatric intensive care unit. Optimal provision of nutritional support should form an integral part of paediatric critical care. Enteral nutrition is cost-effective, maintains gut integrity and reduces infectious complications when compared to parenteral nutrition.

Objectives

An audit performed in January 2017 showed poor compliance to a local enteral nutrition feeding guidelines. Our aim therefore was to improve staff understanding on the importance of adequate nutrition and as a result improve guideline compliance.

Methods

We updated our enteral feeding guideline and instigated an educational drive within the Critical Care Department. We held weekly teaching sessions and made the guideline more easily accessible to staff. Flow diagrams were produced and laminated copies placed in each patient bedspace. Posters with prompts on the early introduction of enteral feeding were displayed on the unit and assessment of feeding practices for each patient made a standard part of medical handover.

Following a 2-month education period we performed a re-audit to check if compliance to the guideline had improved.

Results

Our re-audit showed improvements in unit compliance to the enteral feeding guideline. In particular there was a vast improvement in the number of children being assessed for enteral nutrition within 24hrs of admission (82% to 100%) and commencement of age appropriate feeds (47% to 72%).

Conclusion

Continued efforts to educate staff on the importance of optimal nutrition should be an aim with quarterly audits performed to track improvements and drive change.