scholarly journals Paediatric intensive care nurses' decision-making around gastric residual volume measurement

2017 ◽  
Vol 22 (5) ◽  
pp. 293-297 ◽  
Author(s):  
Lyvonne N Tume ◽  
Lynne Latten ◽  
Lindsay Kenworthy
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Volume Measurement ◽  
Paediatric Intensive Care ◽  
Residual Volume ◽  
Gastric Residual Volume ◽  
Intensive Care Nurses

scholarly journals Can they stomach it? Parent and practitioner acceptability of a trial comparing gastric residual volume measurement versus no gastric residual volume in UK NNU and PICUs: a feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Elizabeth Deja ◽  
Louise Roper ◽  
Lyvonne N. Tume ◽  
Jon Dorling ◽  
Chris Gale ◽  
...  
Keyword(s):  
Intensive Care ◽  
Focus Groups ◽  
Feasibility Study ◽  
Research Question ◽  
Tube Feeding ◽  
Careful Consideration ◽  
Paediatric Intensive Care ◽  
Residual Volume ◽  
Gastric Residual Volume ◽  
Increased Risk

Abstract Background Routine measurement of gastric residual volume (GRV) to guide feeding in neonatal and paediatric intensive care is widespread. However, this practice is not evidence based and may cause harm. As part of a feasibility study, we explored parent and practitioner views on the acceptability of a trial comparing GRV measurement or no GRV measurement. Methods A mixed-methods study involving interviews and focus groups with practitioners and interviews with parents with experience of tube feeding in neonatal and/or paediatric intensive care. A voting system recorded closed question responses during practitioner data collection, enabling the collection of quantitative and qualitative data. Data were analysed using thematic analysis and descriptive statistics. Results We interviewed 31 parents and nine practitioners and ran five practitioner focus groups (n=42). Participants described how the research question was logical, and the intervention would not be invasive and potential benefits of not withholding the child’s feeds. However, both groups held concerns about the potential risk of not measuring GRV, including delayed diagnosis of infection and gut problems, increased risk of vomiting into lungs and causing discomfort or pain. Parent’s views on GRV measurement and consent decision making were influenced by their views on the importance of feeding in the ICU, their child’s prognosis and associated comorbidities or complications. Conclusions The majority of parents and practitioners viewed the proposed trial as acceptable. Potential concerns and preferences were identified that will need careful consideration to inform the development of the proposed trial protocol and staff training.

scholarly journals Routine gastric residual volume measurement to guide enteral feeding in mechanically ventilated infants and children: the GASTRIC feasibility study

2020 ◽  
Vol 24 (23) ◽  
pp. 1-120 ◽  
Author(s):  
Lyvonne N Tume ◽  
Kerry Woolfall ◽  
Barbara Arch ◽  
Louise Roper ◽  
Elizabeth Deja ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Health Care Professionals ◽  
Delphi Study ◽  
Paediatric Intensive Care ◽  
Residual Volume ◽  
Gastric Residual Volume ◽  
Work Package ◽  
Paediatric Intensive Care Units

Background The routine measurement of gastric residual volume to guide the initiation and delivery of enteral feeding is widespread in paediatric intensive care and neonatal units, but has little underlying evidence to support it. Objective To answer the question: is a trial of no gastric residual volume measurement feasible in UK paediatric intensive care units and neonatal units? Design A mixed-methods study involving five linked work packages in two parallel arms: neonatal units and paediatric intensive care units. Work package 1: a survey of units to establish current UK practice. Work package 2: qualitative interviews with health-care professionals and caregivers of children admitted to either setting. Work package 3: a modified two-round e-Delphi survey to investigate health-care professionals’ opinions on trial design issues and to obtain consensus on outcomes. Work package 4: examination of national databases to determine the potential eligible populations. Work package 5: two consensus meetings of health-care professionals and parents to review the data and agree consensus on outcomes that had not reached consensus in the e-Delphi study. Participants and setting Parents of children with experience of ventilation and tube feeding in both neonatal units and paediatric intensive care units, and health-care professionals working in neonatal units and paediatric intensive care units. Results Baseline surveys showed that the practice of gastric residual volume measurement was very common (96% in paediatric intensive care units and 65% in neonatal units). Ninety per cent of parents from both neonatal units and paediatric intensive care units supported a future trial, while highlighting concerns around possible delays in detecting complications. Health-care professionals also indicated that a trial was feasible, with 84% of staff willing to participate in a trial. Concerns expressed by junior nurses about the intervention arm of not measuring gastric residual volumes were addressed by developing a simple flow chart and education package. The trial design survey and e-Delphi study gained consensus on 12 paediatric intensive care unit and nine neonatal unit outcome measures, and identified acceptable inclusion and exclusion criteria. Given the differences in physiology, disease processes, environments, staffing and outcomes of interest, two different trials are required in the two settings. Database analyses subsequently showed that trials were feasible in both settings in terms of patient numbers. Of 16,222 children who met the inclusion criteria in paediatric intensive care units, 12,629 stayed for > 3 days. In neonatal units, 15,375 neonates < 32 weeks of age met the inclusion criteria. Finally, the two consensus meetings demonstrated ‘buy-in’ from the wider UK neonatal communities and paediatric intensive care units, and enabled us to discuss and vote on the outcomes that did not achieve consensus in the e-Delphi study. Conclusions and future work Two separate UK trials (one in neonatal units and one in paediatric intensive care units) are feasible to conduct, but they cannot be combined as a result of differences in outcome measures and treatment protocols, reflecting the distinctness of the two specialties. Trial registration Current Controlled Trials ISRCTN42110505. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 23. See the NIHR Journals Library website for further project information.

Gastric residual volume measurement in the intensive care unit: an international survey reporting nursing practice

2018 ◽  
Vol 23 (5) ◽  
pp. 263-269 ◽  
Author(s):  
Nurten Ozen ◽  
Stijn Blot ◽  
Volkan Ozen ◽  
Ayse Arikan Donmez ◽  
Pınar Gurun ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nursing Practice ◽  
Volume Measurement ◽  
International Survey ◽  
Residual Volume ◽  
Gastric Residual Volume

scholarly journals Gastric Residual Volume Measurement in U.K. PICUs

2019 ◽  
Vol 20 (8) ◽  
pp. 707-713 ◽  
Author(s):  
Lyvonne N. Tume ◽  
Barbara Arch ◽  
Kerry Woolfall ◽  
Lynne Latten ◽  
Elizabeth Deja ◽  
...  
Keyword(s):  
Volume Measurement ◽  
Residual Volume ◽  
Gastric Residual Volume

Attitudes to End-of-Life Decisions in Paediatric Intensive Care

2009 ◽  
Vol 16 (1) ◽  
pp. 83-92 ◽  
Author(s):  
Aslihan Akpinar ◽  
Muesser Ozcan Senses ◽  
Rahime Aydin Er
Keyword(s):  
Intensive Care ◽  
End Of Life ◽  
Ethical Issues ◽  
Paediatric Intensive Care ◽  
End Of Life Decisions ◽  
Care Experience ◽  
Intensive Care Nurses ◽  
Futile Treatment ◽  
Intravenous Nutrition ◽  
Life Decisions

The aim of this study was to assess attitudes of intensive care nurses to selected ethical issues related to end-of-life decisions in paediatric intensive care units. A self-administered questionnaire was distributed in 2005 to intensive care nurses at two different scientific occasions in Turkey. Of the 155 intensive care nurse participants, 98% were women. Fifty-three percent of these had intensive care experience of more than four years. Most of the nurses failed to agree about withholding (65%) or withdrawing (60%) futile treatment. In addition, 68% agreed that intravenous nutrition must continue at all costs. In futile treatment cases, the nurses tended to leave the decision to parents or act maternalistically. The results showed that intensive care nurses could ignore essential ethical duties in end-of-life care. We suggest that it is necessary to educate Turkish intensive care nurses about ethical issues at the end of life.

scholarly journals Physicians' perceptions about managing enteral nutrition and the implementation of tools to assist in nutritional decision-making in a paediatric intensive care unit

2020 ◽  
Vol 33 (3) ◽  
pp. 219-227 ◽  
Author(s):  
Clémence Moullet ◽  
Elodie Schmutz ◽  
Jocelyne Laure Depeyre ◽  
Marie-Hélène Perez ◽  
Jacques Cotting ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Enteral Nutrition ◽  
Paediatric Intensive Care Unit ◽  
Paediatric Intensive Care
Sign in / Sign up

Export Citation Format

Share Document