The effect of care bundle application on enteral nutrition complications and some nutritional parameters in intensive care unit patients receiving enteral nutrition through nasogastric

This thesis was performed as a non-randomized experimental study with control and intervention groups to examine the effect of care bundle application on enteral nutrition complications and some nutritional parameters in intensive care patients who received enteral nutrition via nasogastric tube. The study was carried out in Şanlıurfa Mehmet Akif Inan Training and Research Hospital Neurology and General Intensive Care Units between July 2022 and May 2023. Thirty patients in both groups were followed up for 14 days. Nurse and Patient Descriptive Information Form, Enteral Nutrition Complications and Nutrition Parameters Follow-up Forms were used to collect data. In the light of current literature, an evidence-based care bundle consisting of four parameters and 16 nursing interventions was developed and expert opinion was obtained. In the patients in the control group, the hospital's current enteral nutrition standard practices were followed and recorded. Afterwards, the nurses were given training on the implementation of the enteral nutrition care bundle. In the patients in the interventiongroup, the application status of the parameters in the care bundle by the nurses was monitored and recorded daily by the researcher. Statistical analysis of the data was done with SPSS 25.0 program, independent sample T test and group comparisons were made with Mann Whitney U test. Compliance rates of nurses to the care bundle in patients in the interventiongroup were found to be significantly higher than those in the control group. Vomiting, NG tube-induced nasal injury, tube sticking to the esophagus, and tube occlusion were significantly lower in the interventiongroup. The daily nutrient volume and daily calorie intake given to the patients in the interventiongroup were significantly higher than the control group, starting from the 6th day. The cumulative calorie deficit was significantly lower in the interventiongroup on all days of follow-up. Although the levels of albumin, prealbumin and transferrin, which are nutritional parameters, were significantly higher in the interventiongroup, they tended to decrease in both groups. CRP levels were significantly lower in the interventiongroup on day 1 and day 14 as a desirable result. Upper arm, waist and hip circumference measurement values were found to be significantly lower than the 1st day measurements in intragroup comparisons in both groups. In conclusion; it was observed that the application of enteral nutrition care bundle contributed to the reduction of enteral nutrition complications and had a positive effect on nutritional parameters.