Nutritional rehabilitation after ICU – does it happen: a qualitative interview and observational study


  • Judith Merriweather BSc, MSc,

    Research Dietitian, Corresponding author
    1. The University of Edinburgh, The Chancellor's Building, Edinburgh, UK
    • Correspondence: Judith Merriweather, Research Dietitian, The University of Edinburgh, Room GU 309, The Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK. Telephone: +44 (0)131 2426394.


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  • Pam Smith PhD, MSc, BNurs, RGN, RNT,

    Professor of Nurse Education and Head of Nursing Studies
    1. School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
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  • Timothy Walsh BSc, MBChB, FRCA, FRCP, MD, MSc

    Professor of Critical Care
    1. School of Clinical Sciences and Community Health, The University of Edinburgh, Edinburgh, UK
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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,


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.