-Shared my recommendations at the MICU huddle, a daily interdisciplinary team meeting. - Enteral nutrition -Food &/OR Nutrient -Food/Nutrition-Related -Enteral Nutrition -Viewed tube feeding administration Delivery: Enteral and History: Food and Formula: Not correct pump at bedside with 1.2 inconsistent with Parenteral Nutrition→ Nutrient Intake→ formula; energy needs kcal/mL formula when my needs Enteral Nutrition Enteral and Parenteral not met recommendations were (modify concentration Nutrition Intake (Enteral -Enteral Nutrition using a 2 kcal/mL formula. of enteral nutrition) nutrition Order: order placed -Notified nursing of this 6/29/16 formula/solution) but not correct order to error but then later -Food/Nutrition-Related meet needs returned to the pump to History: Food and find a 1.5 kcal/mL bag Nutrient hanging. Administration→ Diet History (Diet Order: Enteral Nutrition Order) - Inadequate enteral -Food &/OR Nutrient -Food/Nutrition-Related -Enteral Nutrition -Notified Fellow at MICU nutrition infusion Delivery: Enteral and History: Food and Formula: Once tube huddle that once tube Parenteral Nutrition→ Nutrient Intake→ feeding resumed; feeding was turned back Enteral Nutrition Enteral and Parenteral correct formula for on, I had new (Modify rate of enteral Nutrition Intake (Enteral new recommendations recommendations. nutrition) nutrition was used (1.5 -Followed nursing flow formula/solution) kcal/mL) sheets in order to 6/30/16 -Food/Nutrition-Related -Enteral nutrition determine when Veteran History: Food and Order: order placed became more Nutrient but not correct order to hemodynamically stable. Administration→ Diet meet needs -Monitored tube feeding History (Diet Order: pump history and flow Enteral Nutrition Order) sheets to determine if rate had advanced.
-Shared my recommendations at the MICU huddle, a daily interdisciplinary team meeting. 6/29/16 - Enteral nutrition administration inconsistent with needs -Food &/OR Nutrient Delivery: Enteral and Parenteral Nutrition→ Enteral Nutrition (modify concentration of enteral nutrition) -Food/Nutrition-Related History: Food and Nutrient Intake→ Enteral and Parenteral Nutrition Intake (Enteral nutrition formula/solution) -Food/Nutrition-Related History: Food and Nutrient Administration→ Diet History (Diet Order: Enteral Nutrition Order) -Enteral Nutrition Formula: Not correct formula; energy needs not met -Enteral Nutrition Order: order placed but not correct order to meet needs -Viewed tube feeding pump at bedside with 1.2 kcal/mL formula when my recommendations were using a 2 kcal/mL formula. -Notified nursing of this error but then later returned to the pump to find a 1.5 kcal/mL bag hanging. 6/30/16 - Inadequate enteral nutrition infusion -Food &/OR Nutrient Delivery: Enteral and Parenteral Nutrition→ Enteral Nutrition (Modify rate of enteral nutrition) -Food/Nutrition-Related History: Food and Nutrient Intake→ Enteral and Parenteral Nutrition Intake (Enteral nutrition formula/solution) -Food/Nutrition-Related History: Food and Nutrient Administration→ Diet History (Diet Order: Enteral Nutrition Order) -Enteral Nutrition Formula: Once tube feeding resumed; correct formula for new recommendations was used (1.5 kcal/mL) -Enteral nutrition Order: order placed but not correct order to meet needs -Notified Fellow at MICU huddle that once tube feeding was turned back on, I had new recommendations. -Followed nursing flow sheets in order to determine when Veteran became more hemodynamically stable. -Monitored tube feeding pump history and flow sheets to determine if rate had advanced.
allison_k_fassler_clinical_case_study.docx