Nutrition care processes across hospitalisation in critically ill patients with COVID-19 in Australia: A multicentre prospective observational study.
Emma J Ridley, Lee-Anne S Chapple, Kate Ainscough and 14 others
PMID 36806392WHAT IT FOUND
Only half of ICU survivors with COVID-19 were screened for malnutrition.
Patients eating orally received significantly less dietitian care than those ventilated. Nutrition handovers were frequently missing at ICU discharge, leaving ward teams without key information.
Key findings
01Malnutrition screening occurred in only 50% of patients in the ICU and 50% on the ward.
02Patients who were mechanically ventilated received dietetic input much more frequently than those who were not ventilated.
03Nutrition progress was not mentioned in the handover at ICU discharge for 34% of patients.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study only included patients who survived their ICU admission, so it does not reflect the experience of those who died. Data were collected during the initial phases of the pandemic, when staffing and resources were under extreme pressure, which may not reflect current practice. Only 77% of eligible patients at participating sites were captured, and the reason for this missing data is unknown. The study was observational, so it describes what happened but cannot determine why certain patients received more or less care. Some variables were subjectively determined, and nutritional intake itself was not quantified.
Declared interests
The authors declared no specific funding from public, commercial, or not-for-profit sectors. Four authors hold leadership or editorial positions with the journal publishing the study (Australian Critical Care), but the manuscript was managed by a different editor to mitigate conflicts of interest.
The easy way to misread this
Do not interpret the lower rates of dietetic input for non-ventilated patients as evidence that they did not need it. The study found that patients eating orally were less likely to be seen, but this reflects historical prioritisation of more acutely ill patients rather than a clinical determination that oral nutrition was sufficient. Nurses and other clinicians should not assume that patients without artificial feeding are at low nutritional risk.