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