A recent change in nursing practice based on evidence.

Sample Answer

A Recent Change in Nursing Practice Based on Evidence:

• Practice Change: The shift towards earlier and more liberal use of enteral nutrition (EN) for critically ill patients, particularly those in the Intensive Care Unit (ICU), often starting within 24-48 hours of admission or intubation, and prioritizing EN delivery even if the patient requires vasopressor support. This contrasts with older practices that sometimes delayed feeding due to concerns about hemodynamic instability or the risk of feeding intolerance.
• The Evidence: Multiple large randomized controlled trials (RCTs) and meta-analyses (e.g., part of the "evidence-based ICU" movement, including studies by Dr. Derek Cuthbertson and others) demonstrated that early initiation of EN is associated with improved clinical outcomes, such as reduced infectious complications (pneumonia, bacteremia), shorter lengths of ICU stay, and potentially lower mortality rates, compared to delayed feeding. The evidence suggests that the metabolic and immune benefits of providing nutrition early outweigh the perceived risks in most critically ill adults, and that strategies exist to manage potential issues like gastric residual volumes (GRVs) and aspiration risk. Guidelines from organizations like the Society of Critical Care Medicine (SCCM) and the European Society of Parenteral and Enteral Nutrition (ESPEN) now strongly recommend early EN.A Recent Change in Nursing Practice Based on Evidence: