ASPEN Safe Practice for Enteral Nutrition Therapy, 201: An Update

From early on in my career as a NICU nurse and later as a clinical nurse leader, I have always found great value in learning as much as possible from others with the goal of continuously improving my clinical knowledge.

I always find it so interesting to review evidence-based research, best practices, and learn from other institutions’ experiences. My love for reviewing evidence-based research was carried over and further enhanced while working at a tertiary medical center seeking Magnet designation. The journey reinforced to me the importance of using evidence-based research to improve clinical practice and provide excellence in clinical care.

In comparison to many areas of medical practice, the art and science of Neonatology is relatively young. There is just not enough evidence-based research available for pediatric and neonatal populations. It is critically important to have resources available that have reviewed and compiled all relevant literature and put it together in a format that is easy to review.

I am excited about the new release from the American Society for Parenteral and Enteral Nutrition (ASPEN) on enteral nutrition practice recommendations. On November 10, 2016, ASPEN announced the update in their digital newsletter, “ASPEN Clinical Practice Highlights.”  And, in January of this year, they released the full document in the Journal of Parenteral and Enteral Nutrition.¹  This is the most recent, complete update since 2009. The long-awaited practice recommendations for safe enteral nutrition have been revealed and are a welcome resource for clinicians of disciplines.

The previous document was 46 pages. The current document is much more robust and has expanded to a whopping 89 pages, which is a much longer document.

A few noticeable changes in the update:

• A different format from the previous, this one distributes the information in large sections providing background, practice recommendations, and rationale. The sections are uniquely grouped and identified by key questions related to enteral practice with safety implications.¹
• The document touches on many areas of practice and provides recommendations on safe practices starting at assessment, prescribing and placing the enteral feeding order progresses to preparation of feedings, administration and delivery, and documentation, and wraps up with recommendations for ongoing quality improvement. And, there is much, much more…
• At the end of almost every section there are “areas of future research” highlighting opportunities for the expansion of this body of evidence.

My personal favorite, and one of the many reasons that this document is a go-to resource, is the Rationale section.  Following every list of recommendations is a rationale. This section provides a lengthy explanation and sources that support the recommendations. The reference list is extensive and exhausting; a clinical researchers dream!

I hope that you will have a chance to review this document and keep it on the shelf as a go to resource.

References

1. Boullata, J, Carrera, A, Harvey L, et al. ASPEN Safe Practices for Enteral Nutrition Therapy. Journal of Parenteral and Enteral Nutrition.  2017;41(1)15-103