Nurses' decision‐making around gastric residual volume measurement in UK adult intensive care: A four‐centre survey

Tume, Lyvonne N., Lynes, Andrew A., Waugh, Victoria, Johnston, Brian W., Kazi, Aayesha, Truman, Nicholas and Szakmany, Tamas ORCID: https://orcid.org/0000-0003-3632-8844 2024. Nurses' decision‐making around gastric residual volume measurement in UK adult intensive care: A four‐centre survey. Nursing in Critical Care 10.1111/nicc.13056

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Abstract

Background: Despite increasing evidence of the potential inaccuracy and unwarranted practice of regular GRV measurement in critically in adults, this practice persists within the United Kingdom. Aim: To explore adult intensive care nurses' decision‐making around the practice of GRV measurement to guide enteral feeding. Methods: A cross‐sectional 16 item electronic survey in four adult intensive care units (ICUs) in England and Wales. Results: Two hundred and seventy‐three responses were obtained across four ICUs with acceptable response rates for most [Unit 1 74 /127 = 58.2%; Unit 2 87/129 = 67.4%; Unit 3 77/120 = 64.1%; Unit 4 35/168 = 20.8%]. Most (243/273 (89%) reported measuring GRV 4–6 hourly, with most (223/273 82%) reporting that the main reason was to assess feed tolerance or intolerance and 37/273 (13.5%) saying their unit protocol required it. In terms of factors affecting decision‐making, volume obtained was the most important factor, followed by the condition of the patient, with aspirate colour and appearance less important. When asked how they would feel about not measuring GRV routinely, the majority (78.2%) of nurses felt worried (140/273 = 51.2%) or very worried (74/273 = 27%). Conclusions: Factors affecting the nurses' decision‐making around GRV were based largely on fear of risk (around vomiting and pulmonary aspiration) and compliance with unit protocols. Relevance to Clinical Practice: Despite increasing evidence suggesting it is unnecessary, nurses' beliefs around the value of this practice persist and it continues to be embedded into unit protocols around feeding.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by/4.0/
Publisher:	Wiley
ISSN:	1362-1017
Date of First Compliant Deposit:	11 March 2024
Date of Acceptance:	14 February 2024
Last Modified:	11 Mar 2024 11:30
URI:	https://orca.cardiff.ac.uk/id/eprint/167077

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