Nutrition Initiation and Advancement Clinical Pathway — PICU/PCU

Goals

To standardize the approach to initiation and advancement of feeding children in the PICU resulting in:

  • Decreased time from PICU admission to initiation of enteral nutrition (NPO time)
  • Decreased time from initiation of enteral nutrition to attainment of goal nutrition (volume and caloric intake per RD recommendation)
  • Decrease in unnecessary and prolonged interruptions to enteral nutrition
  • Decrease in unnecessary use of parenteral nutrition in the PICU

Metrics

Increase

  • Percent of patients initiated on enteral feeds by Day #2 of admission

Decrease

  • Frequency and duration of feed interruptions
  • Time from enteral feed order to initiation of first enteral feed
  • Time from initiation of enteral nutrition to attainment of goal nutrition per RD prescription

Balancing Measures

  • Documented intolerance of feeds
  • Adverse events directly related to initiation of feeds, i.e. documented aspiration post initiation of enteral feeds