Development of a Multidisciplinary Cooperative Nutrition Management Process for Critically Ill Patients—A Delphi Expert Consensus Study

Why It Matters

Standardizing nutrition care in intensive care reduces variability, enhances patient outcomes, and provides a replicable model for hospitals worldwide.

Key Takeaways

• Delphi consensus created 31‑criterion nutrition protocol for ICU patients
• Process spans five stages from admission to discharge
• 20 experts from five provinces participated, 85‑100% agreement
• Multidisciplinary team includes physicians, nurses, dietitians, pharmacists
• Protocol aims to improve safety and effectiveness of nutrition support

Pulse Analysis

Intensive care units have long grappled with inconsistent nutrition practices, despite clear evidence that timely, appropriate feeding can lower infection rates and shorten hospital stays. Existing guidelines from societies such as ASPEN and ESPEN offer broad recommendations, but frontline clinicians often lack a concrete, step‑by‑step workflow that aligns with local resources and multidisciplinary team structures. By translating these high‑level standards into a detailed, five‑phase process, the Chinese study bridges the gap between theory and bedside execution, ensuring that nutrition assessment, prescription, delivery, monitoring, and transition are systematically addressed.

The research employed the Delphi technique, convening 20 seasoned experts—including intensivists, dietitians, pharmacists, and nursing leaders—from Beijing, Zhejiang, Jilin, Guangdong, and Chongqing. Over two rounds, participants refined an initial draft of 31 criteria, achieving 85‑100% consensus on each item. This rigorous, iterative feedback loop not only validated the clinical relevance of each step but also fostered buy‑in across specialties, a critical factor for successful implementation. The bifurcated design—separating overall nutrition management from enteral nutrition specifics—recognizes the nuanced decisions clinicians must make for patients with varying gastrointestinal function and metabolic needs.

If adopted widely, the protocol could streamline nutrition workflows, reduce delays in initiating enteral feeding, and minimize complications such as aspiration or overfeeding. Hospitals can leverage the checklist‑style format to train staff, audit performance, and integrate with electronic health records for real‑time decision support. Moreover, the study’s methodology offers a template for other regions seeking to tailor international guidelines to local practice patterns, potentially elevating the standard of critical care nutrition on a global scale.