In our intensive care unit (ICU), the “traditional order” for enteral nutrition included 2 pieces of information:

We were finding that the lack of standardization of the enteral nutrition order often resulted in patients getting “stuck” at initiating rates of 30 mL/h because the order was missing a rate of increase and a goal rate. Additionally, the traditional order made no accommodations for those patients who experienced elevated gastric residual volumes (GRVs), resulting in extended withholding of feedings. The incompleteness of the traditional order for enteral nutrition set patients up to receive suboptimal nutrition.

Inspired by the desire to provide the best possible nutrition for our critical care patients, the ICU clinical coordinator conducted a literature search. It was not surprising that the literature supported not only early initiation of enteral nutrition in critical care patients, but also timely achievement of nutritional goals...

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