Nutritional rehabilitation after ICU – does it happen: a qualitative interview and observational study
Article first published online: 27 MAY 2013
© 2013 John Wiley & Sons Ltd
Journal of Clinical Nursing
Special Issue: ICU Special Section
Volume 23, Issue 5-6, pages 654–662, March 2014
How to Cite
Merriweather, J., Smith, P. and Walsh, T. (2014), Nutritional rehabilitation after ICU – does it happen: a qualitative interview and observational study. Journal of Clinical Nursing, 23: 654–662. doi: 10.1111/jocn.12241
- Issue published online: 19 FEB 2014
- Article first published online: 27 MAY 2013
- Manuscript Accepted: 20 DEC 2012
- Chief Scientist Office
- clinical practice;
- grounded theory;
Aims and objectives
To compare and contrast current nutritional rehabilitation practices against recommendations from National Institute for Health and Excellence guideline Rehabilitation after critical illness (NICE) (2009, http://www.nice.org.uk/cg83).
Recovery from critical illness has gained increasing prominence over the last decade but there is remarkably little research relating to nutritional rehabilitation.
The study is a qualitative study based on patient interviews and observations of ward practice.
Seventeen patients were recruited into the study at discharge from the intensive care unit (ICU) of a large teaching hospital in central Scotland in 2011. Semi-structured interviews were conducted on transfer to the ward and weekly thereafter. Fourteen of these patients were followed up at three months post-ICU discharge, and a semi-structured interview was carried out. Observations of ward practice were carried out twice weekly for the duration of the ward stay.
Current nutritional practice for post-intensive care patients did not reflect the recommendations from the NICE guideline. A number of organisational issues were identified as influencing nutritional care. These issues were categorised as ward culture, service-centred delivery of care and disjointed discharge planning. Their influence on nutritional care was compounded by the complex problems associated with critical illness.
The NICE guideline provides few nutrition-specific recommendations for rehabilitation; however, current practice does not reflect the nutritional recommendations that are detailed in the rehabilitation care pathway.
Relevance to clinical practice
Nutritional care of post-ICU patients is problematic and strategies to overcome these issues need to be addressed in order to improve nutritional intake.