Program ensures ICU patients receive proper nutrition without compromising coverage.
They are some of the sickest patients in the hospital, requiring constant monitoring from specialized staff. Many are recovering from severe illnesses, injuries or surgery that may prevent them from breathing, moving or speaking without the use of medical equipment. In this state, eating can be the last thing on a patient’s mind. However, newer research shows that patients who receive food by mouth or feeding tube early in their treatment may get out of the hospital quicker, with fewer complications or risks.
“A lot of literature has been written in support of early feeding,” said Carol Murphy, RN, a clinical education specialist for critical care nurses. “It can reduce the risk of sepsis and promote wound healing.”
Nursing staff at UF Health Jacksonville created an Enteral Access Team, or EAT, to ensure critically ill patients receive timely nutrition without limiting resources or overtaxing staff in the hospital’s intensive care units.
EAT is made up of 12 specially trained ICU nurses. Using electromagnetic imaging technology called CORTRAK 2, an EAT member can view real-time representation of the nasogastric feeding tube’s tip as it is placed in the stomach. This allows them to immediately provide nutrition. Prior to this program, the wait times for tube placement could take several hours. Patients are also spared radiation exposure, as the previous method for placing feeding tubes required X-ray imaging.
“We began training nurses for EAT in 2015,” Murphy said. “We conducted formal classroom training and competency verification with nurses who had previous experience with CORTRAK 1. Then we tracked placements with CORTRAK 2 for two years. Once the nurses were successfully placing the feeding tubes in the desired location more than 95 percent of the time, the team was implemented on the unit.”
The team also eases the strain on bedside ICU nurses. Previously, nurses trained to place feeding tubes had to step away from their assigned patients for long periods of time to complete the procedure for patients elsewhere in the hospital. These conditions created stress for the critical care units and a concern for patient safety. Now, nurses can alert the team when a physician orders a feeding tube placement.
“Any patient unable to take nutrition by mouth may be a candidate for a nasogastric feeding tube,” Murphy said. “That may include patients affected by stroke, trauma or types of surgery impeding the ability for oral nutrition.”
Murphy says nurses at UF Health North are currently in training for enteral access placement so they can serve their patients and staff in the same way.
“This system allows us to troubleshoot tubes,” Murphy said. “We don’t have to remove one and place another. We’re reducing radiation for our patients, saving the organization money, and we are able to feed a patient almost immediately, improving our quality of care.”