Early enteral nutrition support for patients with acute pancreatitis in the inpatient setting: a best practice implementation project

Author:

Xie Jieying12,Cai Yuhan1,Xu Huiying2,Peng Yang3,McArthur Alexa4

Affiliation:

1. Emergency Department, Nanfang Hospital, Southern Medical University, Guangzhou, China

2. Nanfang Nursing Centre for Evidence-Based Practice: A JBI Centre of Excellence, Guangzhou, China

3. Gastroenterology Department, Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou, China

4. JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia

Abstract

ABSTRACT Introduction: Acute pancreatitis is a major disease that endangers the health and lives of people. Historically, clinical therapy has recommended. that patients with acute pancreatitis remain nil by mouth. As one of the therapies recommended in recent guidelines, early enteral nutrition support reduces the incidence of infectious complications and reduces the risk of severe conditions. However, early enteral nutrition support has not been optimally implemented within clinical practice for acute pancreatitis inpatients. Objectives: This evidence implementation project aimed to increase compliance with best practice recommendations for early enteral nutrition support, while standardizing the enteral nutrition support process and reducing the incidence of delayed enteral nutrition. Methods: The project was guided by the JBI Evidence Implementation Framework, which is grounded in the audit and feedback process, as well as a seven-stage structured approach to identifying and managing barriers to compliance with recommended practices. Results: In the baseline audit, compliance rates were low for all evidence-based audit criteria. Four of the eight criteria showed 0% compliance. However, after implementation, all eight criteria achieved a minimum compliance rate of 60%, with Site 2 achieving 90% to 100% compliance. In addition, nurses improved their knowledge and skills in early enteral nutrition support. The incidence of delayed enteral nutrition also fell from 86.2% to 20.7% at both study sites. The implementation strategy included a training program, psychological interventions, and financial and human resource support. Conclusion: This project not only significantly improved early enteral nutrition support for acute pancreatitis patients, but also increased nurses’ knowledge and practice skills, standardized the process of enteral nutrition support, and reduced the incidence of delayed enteral nutrition. Spanish abstract: http://links.lww.com/IJEBH/A177

Publisher

Ovid Technologies (Wolters Kluwer Health)

Reference17 articles.

1. American College of Gastroenterology Guideline: management of acute pancreatitis;Tenner;ACG,2013

2. Clinical-alimentary tract burden of gastrointestinal disease in the United States: 2012 update;Peery;Gastroenterol,2012

3. Pancreas Study Group, Chinese Society of Gastroenterology, Chinese Medical Association, Editorial Board of Chinese Journal of Pancreatology, Editorial Board of Chinese Journal of Digestion. Chinese guidelines for the management of acute pancreatitis;J Clin Hepatol,2019

4. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus;Banks;Gut,2013

5. Immediate oral feeding in patients with mild acute pancreatitis is safe and may accelerate recovery: a randomized clinical study;Eckerwall;Clin Nutr,2007

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