Sep 14, 2025
1:00 PM2:00 PM
Poster Session
P441 - INCREASED PROTEIN DELIVERY IN THE ICU AFTER AN AUDIT AND FEEDBACK NUTRITIONAL INTERVENTION: A PROSPECTIVE OBSERVATIONAL STUDY
P441
INCREASED PROTEIN DELIVERY IN THE ICU AFTER AN AUDIT AND FEEDBACK NUTRITIONAL INTERVENTION: A PROSPECTIVE OBSERVATIONAL STUDY
T. H. Løland1,2,*, S. H. Fjeldstad1, A. B. Kildal2,3, M. I. Hagve2,4
1Clinical Nutrition Centre, University Hospital of North Norway, 2Department of Clinical Medicine, UiT The Arctic University of Norway, 3Department of Anesthesiology and Intensive Care, 4Department of Gastrointestinal Surgery, University Hospital of North Norway, Tromsø, Norway
Rationale: Critically ill patients are at increased risk of malnutrition and frequently in need of nutrition support. There is a known gap between guidelines and nutritional practice in the ICU. Audit and feedback is known to improve quality in health care services. This study aimed to determine if an audit and feedback could improve nutritional practice and adherence to nutrition guidelines in the ICU.
Methods: This was a single-centre observational study comparing nutritional practice before and after an audit and feedback. Data were collected prospectively from ICU admission for up to seven days. Based on the current practice and barriers identified in interviews with involved health care personnel, strategies to improve practice were implemented. These included feedback through dietitian teaching, improved local guidelines and optimized nutritional formulas.
Results: A total of 79 and 86 patients were included in the two groups. There was an overall increase in protein delivery (p<0.05), improving from day four and onwards (day four; 0.4 g/kg/day (95% CI: 0.2-0.7) vs 0.6 (0.4-0.7), day five; 0.7 (0.3-0.9) vs 0.8 (0.6-1.1), day six; 0.9 (0.6-1.1) vs 1.1 (0.8-1.2), day seven; 0.9 (0.8-1.2) vs 1.0 (0.8-1.2). The achievement of recommended energy targets improved from day four and onwards (day four; 21 vs 46% p<0.05, day five; 36 vs 52% p=0.12; day six; 30 vs 59% p<0.05, day seven; 39 vs 62% p=0.05).
Conclusion: An audit and feedback approach improved nutritional practice in regards to increasing protein delivery and reaching recommended energy targets. The use of audit and feedback may be beneficial to improve adherence to guidelines, but even with this approach guideline goals are still challenging to achieve.
Disclosure of Interest: None declared