Using Nurse-Driven Protocols to Eliminate Routine Gastric Residual Volume Measurements: A Retrospective Study

Author(s): Marshall Smith, DNP, FNP-BC, CCRN, Millie Smith, MS, RD, LD, CNSC, Katie N. Robinson, PhD, RD, LD, CNSC

Contact Hours 1.00

CERP A 1.00

Expires Aug 01, 2025

Topics: Gastrointestinal

Population: Adult

Role: Staff

Member: Free
NonMember: $10.00

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Activity Summary

Required reading for all learners: Implicit Bias impacts patient outcomes

The 2021 Critical Care Nutrition systematic reviews demonstrated improved nutritional outcomes and no effect on mortality or length of stay in patients who do not receive routine GRV assessments. Despite these evolving guidelines, clinical practice has been slow to make the change. This article depicts a study about the elimination of routine gastric residual volume monitoring in adult ICU patients to achieve a higher delivery of ordered enteral nutrition. This was achieved without increased rates of emesis or aspiration pneumonia or length of stay. These findings indicate that the use of a protocol for practice change and mandatory in-service training can effect changes in nursing practice.


  • Describe current guidance surrounding monitoring patient tolerance to enteral nutrition support.
  • Identify best practices and the method used to support and implement evidence-based practice change within this retrospective study.
  • Describe the benefit of nurse-driven protocols to adopt and sustain practice change.

Continuing Education Disclosure Statement

Successful Completion

Learners must attend/view/read the entire activity, read Implicit Bias impacts patient outcomes, and complete the associated evaluation to be awarded the contact hours or CERP. No partial credit will be awarded.


The American Association of Critical-Care Nurses is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Provider approved by the California Board of Registered Nursing, Provider number CEP 1036, for 1.00 contact hours.

Accreditation refers to recognition of continuing education only and does not imply AACN, ANCC, or CBRN approval or endorsement of any commercial products discussed or displayed in conjunction with this educational activity.


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