P513 - OPTIMIZING THE TRANSITION FROM TOTAL PARENTERAL NUTRITION TO ENTERAL NUTRITION: A QUALITY IMPROVEMENT INITIATIVE

P513

OPTIMIZING THE TRANSITION FROM TOTAL PARENTERAL NUTRITION TO ENTERAL NUTRITION: A QUALITY IMPROVEMENT INITIATIVE

A. A. Alfehaidi^1,*

¹HMC, Doha, Qatar

 

Rationale: The transition from total parenteral nutrition (TPN) to enteral nutrition (EN) is a critical process in the nutritional management of critically ill patients. Proper execution of this transition can significantly impact patient outcomes, reduce complications, and optimize resource utilization.the aim is To implement and evaluate a standardized protocol for transitioning patients from TPN to EN, emphasizing the role of dietitians and focusing on improving nutritional outcomes without complications.

Methods: This quality improvement project was conducted in a 20-bed intensive care unit over a 6-month period. A multidisciplinary team, led by dietitians, developed a standardized transition protocol. Key steps included:

Daily nutritional assessment by dietitians

Gradual introduction of EN while tapering TPN

Monitoring of gastrointestinal tolerance

Adjustment of feeding rates based on patient response

Complete transition to EN when 90% of nutritional goals were met enterally

Data on transition time, nutritional adequacy, and complications were collected pre- and post-implementation.

Results:  Post-implementation data showed:

Reduction in average transition time from 2 weeks to 5 days

Increase in patients achieving 90% of nutritional goals from 30% to 90%

Decrease in TPN-related complications by 60%

No significant increase in EN-related complications

The dietitian-led approach resulted in more frequent nutritional assessments (from 3 to 5 times/week) and timely adjustments to feeding plans.

Conclusion: The implementation of a standardized, dietitian-led protocol for TPN to EN transition significantly improved nutritional outcomes without increasing complications. This quality improvement initiative highlights the crucial role of dietitians in optimizing nutrition therapy and suggests that a structured approach to TPN-EN transition can enhance patient care in critical care settings.

Disclosure of Interest: None declared