Nutritional and Metabolic Diseases
Conditions
Brief summary
Internal medicine resident physicians were provided an ipod with the EN application to assist them in choosing EN formulas for patients during their ICU rotation. The primary outcome was improved initiation of EN within 24 hours of admission. Secondary outcomes include, time to initiate EN, goal calories reached, infections rates, length of stay, mortality, and concordance with clinical guidelines.
Detailed description
Background: Resident physicians are frequently uncomfortable ordering enteral nutrition (EN) and are unaware of the variety of formulas and supplements available for different disease processes. Many depend on a clinical dietitian to assist with recommending EN formulas and patient energy requirements which may not be readily available upon patient admission. This creates a barrier to early initiation of EN and non-compliance with Society of Critical Care Medicine and American Society of Parenteral and Enteral Nutrition clinical guidelines. Objective: Internal medicine resident physicians were provided an ipod with the EN application to assist them in choosing EN formulas for patients during their ICU rotation. The primary outcome was improved initiation of EN within 24 hours of admission. Secondary outcomes include, time to initiate EN, goal calories reached. Design: This study is a retrospective chart review to evaluate the impact of a smart phone/device application (EN application) to assist resident physicians when ordering EN. The study is a single center trial conducted at an academic teaching facility. All patient data was obtained by a retrospective chart review of patients admitted to the intensive care unit (ICU) at The University of Oklahoma Medical Center.
Interventions
OTHERTube Feeding Application
A smart device application was developed and used to help residents determine the best enteral nutrition prescription for patients admitted to the ICU
Sponsors
University of Oklahoma
Study design
Observational model
OTHER
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
1. Admitted to the ICU 2. Require Mechanical Ventilation 3. Physician plans to order enteral nutrition for the patient
Exclusion criteria
1. Death likely within 24 hours 2. Needing parenteral nutrition 3. Cannot tolerate enteral nutrition for any reason
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The primary outcome was improved initiation of EN within 24 hours of admission | The time frame does involve a change in practice. The change is introduction of a smart app- 12 months prior to the smart device being used in the ICU by residents and 12 months during which the smart application was use by the ICU residents | percent of patients with enteral nutrition ordered within 24 hours of admit compared to all patients admitted |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total time to initiate EN | The time frame does involve a change in practice. The change is introduction of a smart app- 12 months prior to the smart device being used in the ICU by residents and 12 months during which the smart application was use by the ICU residents | total hours between admit and when enteral nutrition is ordered |
| Percent of goal calories received prior to discharge from ICU | The time frame does involve a change in practice. The change is introduction of a smart app- 12 months prior to the smart device being used in the ICU by residents and 12 months during which the smart application was use by the ICU residents | percent of calories received (a percent of the total recommended calories for the patient) |
Outcome results
None listed