Clinical guidelines and enteral nutrition support: a survey of dietetic practice in the United Kingdom

Abstract

Background: Artificial nutrition support is used in treating hospital patients and has been shown to reduce hospital stays. The NICE (National Collaborating Centre for Acute Care) guidelines are the first national consensus guidelines for dietetic practice in artificial nutrition. The aim of the current survey was to explore the influence of local and national guidelines, and clinical experience on enteral tube feeding practices in a large cohort of UK dietitians.

Methods: A cross-sectional anonymous online survey of UK registered dietitians was performed.

Results: A total of 681 responses were received. In all, 85% deemed 'clinical experience' to be of greatest influence when initiating a tube feeding regimen; the influence of 'clinical experience' was significantly associated with the number of years in practice (P=<0.001). A total of 70% of respondents were aware of a department feeding protocol with 67% of protocols using a start rate of 24-49 ml/h; furthermore, 65% of respondents reported most commonly using a feeding start rate of 24-49 ml/h and 75% of them reported that their department had a protocol for preventing refeeding syndrome; 23% had mandatory implementation of NICE guidelines.

Conclusions: Enteral feeding practice varies among practitioners. Clinical experience and published clinical guidelines have a pivotal role when treating adult patients that require enteral tube feeding.