Newsletter

[ Vol. 12 No. 3 ] (September - December 2011 )
NBM Practices for procedures in ICU and HDW at hospital kuala lumpur

L Mageswary, M Y Harizah, S Z A Sharifah Mariam
Department of Dietetics & Food Services, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia

A prospective study was done among ventilated patients in ICU and HDW at Hospital Kuala Lumpur. The study objectives were to identify duration the patient use “Nil By Mouth” (NBM) before and after procedures, describe NBM time, determine reasons for NBM time of more than 6 hours and to compare feeding practices in ICU. A total of 34 males and 20 females with mean age of 52.7 years were studied during 1st phase. The results showed, mean feeding initiation time was 1.73 days in ICU with feeding protocol and 2.74 days in ICU without feeding protocol. The study also showed that patients received optimal enteral feeding support in ICU which has a writhen Feeding Protocol. There is no protocol for enteral nutrition support except in one ICU. Prolonged NBM time which was more then 6 hours was due to avoidable reasons and these patients were not able to receive optimal feeding. 

For intervention an Evidence Based Nutrition Support Protocol was developed and implemented. Total of 25 males and 25 females were studied. Mean NBM time before tracheostomy was reduced from 23.96 to 10.20 hours and after procedure was reduced form 14.48 hours to 7.58 hours. For extubation, mean NBM time before procedure was reduced from 6.83 to 5.06 hours and after procedure increased from 5.25 to 5.31 hours. Prolonged NBM time post-intervention were mainly due to patient-related reasons. There was significant reduction in NBM time. Implementation of evidence-based recommendations and multidisciplinary team effort improved the provision of nutrition support.

From  
PENSA 2009
“Energizing Nutrition Support Practice for Life”
June 5-7 2009, Shangri-La Hotel, Kuala Lumpur, Malaysia 
Page: 61