Two issues may arise when patients are receiving enteral feedings: 1) intolerance to the feeding that may translate to decreased caloric intake, and 2) the possibility of aspiration that may contribute to the development of ventilator associated pneumonia. Published guidelines from professional organizations offer excellent direction to the bedside clinician and nutritional support team to help them evaluate the patient’s tolerance and recognize complications related to enteral feedings.

  • Survey your unit’s staff members to determine their current understanding of guidelines and practice. Nurses may vary in their assessment and decision-making practices regarding a patient’s tolerance to enteral feeding.

  • Evaluate current national guidelines for appropriateness to your patient population.

  • Convene an interprofessional team to develop unit standards for monitoring tolerance to tube feedings including: 1) decisions about the limits of gastric residual volumes and frequency of measurement based on the types of feeding...

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