PD093 - DEVELOPMENT OF A STRUCTURED DIETICIAN-LED NUTRITIONAL NOTE IN THE INTENSIVE CARE UNIT

PD093

DEVELOPMENT OF A STRUCTURED DIETICIAN-LED NUTRITIONAL NOTE IN THE INTENSIVE CARE UNIT

E. Dom^1,2,*, Z. Rosseel^1,2,3,4, L. Leemans^1,2,5, L. De Hart^1,2, E. De Waele^1,2,4

¹Clinical Nutrition, UZ Brussel, ²Vitality Research Group, Vrije Universiteit Brussel, ³Pharmacy, UZ Brussel, ⁴Faculty of Medicine and Pharmacy, ⁵Rehabilitation research departement, Vrije Universiteit Brussel, Brussels, Belgium

Rationale: Despite ICU guidelines, a persistent gap exists between targets and actual intake, often leading to under- or overfeeding (1,2). Global studies show that underfeeding is universal(1). ICU energy and protein adequacy range between 65–80% and 58% but decrease on the ward to 58 % and 49 %. (2) This study evaluated how an interdisciplinary team of dietitians and physicians, supported by an automated digital tool, could document and improve nutrition adequacy.  

Methods: A structured dietician-led nutritional note was developed in cooperation with the IT department. The note was implemented in the electronic medical file of patients in the ICU and made it possible to document patients’ energy and protein intake as well as the calculation of needs and adequacies. Based on the notes, individualized nutritional plans were developed, and intake could be documented for the past 24 hours. Documentation included the systematic consideration of intentional and non-intentional calories, enabling continuous adjustment of nutritional strategies. Multidisciplinary collaboration between dieticians, physicians, and nursing staff was an integral part of this project.  

Results: The development of a structured dietician-led nutritional note in the medical file facilitating closer collaboration with allied healthcare practitioners enabled a consistent daily evaluation of nutritional intake and adequacy. The daily adaptation of strategy made it achievable to anticipate a suspected nutritional decline. It supports a more proactive individualized approach to nutritional therapy in the ICU and facilitated interdisciplinary communication.

Conclusion: Implementation of a nutritional note in the medical file at the ICU is feasible, enhances interdisciplinary collaboration, and enables continuous adjustments of nutritional therapies.

References: 1. Bendavid et al, Clinical Nutrition, 2016.

2. De Waele et al, Clinical Nutrition ESPEN, 2025 

Disclosure of Interest: None declared