Nutritional rehabilitation after ICU - does it happen: a qualitative interview and observational study
Nutritional rehabilitation after ICU - does it happen: a qualitative interview and observational study
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DOI：
10.1111/jocn.12241
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发表时间：
2014-03-01
影响因子：
4.2
通讯作者：
Walsh, Timothy
中科院分区：
文献类型：
--
作者：
Merriweather, Judith;Smith, Pam;Walsh, Timothy
Aims and objectivesTo compare and contrast current nutritional rehabilitation practices against recommendations from National Institute for Health and Excellence guideline Rehabilitation after critical illness (NICE) (2009, http://www.nice.org.uk/cg83).BackgroundRecovery from critical illness has gained increasing prominence over the last decade but there is remarkably little research relating to nutritional rehabilitation.DesignThe study is a qualitative study based on patient interviews and observations of ward practice.MethodsSeventeen patients were recruited into the study at discharge from the intensive care unit (ICU) of a large teaching hospital in central Scotland in 2011. Semi‐structured interviews were conducted on transfer to the ward and weekly thereafter. Fourteen of these patients were followed up at three months post‐ICU discharge, and a semi‐structured interview was carried out. Observations of ward practice were carried out twice weekly for the duration of the ward stay.ResultsCurrent nutritional practice for post‐intensive care patients did not reflect the recommendations from the NICE guideline. A number of organisational issues were identified as influencing nutritional care. These issues were categorised as ward culture, service‐centred delivery of care and disjointed discharge planning. Their influence on nutritional care was compounded by the complex problems associated with critical illness.ConclusionsThe NICE guideline provides few nutrition‐specific recommendations for rehabilitation; however, current practice does not reflect the nutritional recommendations that are detailed in the rehabilitation care pathway.Relevance to clinical practiceNutritional care of post‐ICU patients is problematic and strategies to overcome these issues need to be addressed in order to improve nutritional intake.
