Six steps to optimize nutrition support in the ICU

Jun 01, 2018

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New guidelines from the American Society of Parenteral and Enteral Nutrition, aim to ensure that patients receive adequate nutrition during their hospital stay, thereby reducing adverse outcomes

ALISO VIEJO, Calif. – June 1, 2018 – A new nutrition bundle strives to ensure that critically ill patients receive adequate nutrition while hospitalized and seeks to reduce adverse outcomes related to malnutrition.

More than half of patients admitted to critical care units are malnourished, which increases their risk for serious complications and contributes to longer hospital stays and higher healthcare costs. Yet many of those eligible to receive enteral feedings do not receive adequate nutrition while hospitalized.

The American Society of Parenteral and Enteral Nutrition (ASPEN), in conjunction with the Society of Critical Care Medicine, created the nutrition bundle to ensure that patients’ nutrition status is optimized during acute care stays. The bundle is part of ASPEN’s updated guidelines for the assessment and implementation of nutrition support in patients who are critically ill.

New Nutrition Guidelines: Promoting Enteral Nutrition via a Nutrition Bundle”, in the June 2018 issue of Critical Care Nurse (CCN), addresses all components of nutrition, including assessment and interventions.

Ashleigh VanBlarcom, DNP, RN, AGACNP-BC, and Mary Anne McCoy, PhD, RN, ACNP-BC, wrote the article while VanBlarcom was earning a DNP degree at Wayne State University College of Nursing, Detroit, where McCoy is specialty coordinator of the DNP AGACNP and the AGACNP graduate certificate specialties. VanBlarcom is now an acute care nurse practitioner in the thoracic-cardiovascular intensive care unit at the University of Virginia Health System, Charlottesville.

“Malnutrition in hospitals is often overlooked, underdiagnosed and untreated,” VanBlarcom said. “The ASPEN nutrition bundle offers bedside nurses, registered dietitians, providers and other members of the interprofessional team a comprehensive, step-by-step approach to early nutrition.”

The six main components of the nutrition bundle are as follows:

  • Assess patients’ nutrition status to identify those at risk for malnutrition.
  • Initiate and maintain enteral nutrition.
  • Reduce risks for aspiration.
  • Implement enteral feeding protocols.
  • Avoid the use of gastric residual volumes as an assessment of enteral feeding tolerance.
  • Consider parenteral nutrition early, when enteral feedings cannot be initiated.

Together, the components address the distinct aspects of nutrition assessment and related interventions for critically ill patients. As a result, patients can receive adequate nutrition earlier in their hospital stay, which may reduce their risk of adverse outcomes.

As the American Association of Critical-Care Nurses’ bimonthly clinical practice journal for high-acuity, progressive and critical care nurses, CCN is a trusted source of information related to the bedside care of critically and acutely ill patients.

Access the article abstract and full-text PDF by visiting the CCN website at

About Critical Care Nurse:Critical Care Nurse (CCN), a bimonthly clinical practice journal published by the American Association of Critical-Care Nurses, provides current, relevant and useful information about the bedside care of critically and acutely ill patients. The award-winning journal also offers columns on traditional and emerging issues across the spectrum of critical care, keeping critical care nurses informed on topics that affect their practice in high-acuity, progressive and critical care settings.CCN enjoys a circulation of more than 114,000 and can be accessed at

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than half a million acute and critical care nurses and includes more than 200 chapters in the United States. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution.

American Association of Critical-Care Nurses, 101 Columbia, Aliso Viejo, CA 92656-4109; 949-362-2000;;;