Nurses’ decision-making around gastric residual volume measurement in adult intensive care: a four-centre survey

Lyvonne N. Tume*, Andrew A. Lynes, Victoria Waugh, Brian W. Johnston, Aayesha Kazi, Nicholas Truman, Tamas Szakmany

*Corresponding author for this work

Research output: Contribution to journalArticle (journal)peer-review

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Abstract

Background: Despite increasing evidence of the potential inaccuracy and unwarranted practice of regular gastric residual volume (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 gastric residual volume measurement to guide enteral feeding.
Methods: A cross sectional 16 item electronic survey in four adult intensive care units in England and Wales.
Results: Two hundred and seventy-three responses were obtained across four intensive care units 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 gastric residual volume 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 gastric residual volume were based on 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.



Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalNursing in Critical Care
Early online date7 Mar 2024
DOIs
Publication statusPublished - 7 Mar 2024

Keywords

  • enteral nutrition
  • feeding
  • nurse
  • gastric aspirates

Research Institutes

  • Health Research Institute

Research Centres

  • Cardio-Respiratory Research Centre

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