Researchers studied 83 critically ill stroke patients in an intensive care unit to see if a new organized nursing approach to feeding could help patients recover better. They compared patients who received standard care with those who received coordinated feeding support. The patients with coordinated care showed better nutrition levels, fewer stomach problems, and went home from the hospital sooner. This suggests that when nurses use a planned, organized approach to feeding critically ill stroke patients, these patients do better overall and spend less time in the hospital.

The Quick Take

  • What they studied: Whether a coordinated, organized nursing approach to feeding patients in the ICU after a stroke helps them recover better than standard feeding practices
  • Who participated: 83 critically ill stroke patients admitted to one hospital’s intensive care unit between February 2023 and June 2024. After careful matching, 36 patients were in each group (coordinated care vs. standard care)
  • Key finding: Patients who received coordinated feeding care had better nutrition markers, reached their feeding goals faster, experienced fewer stomach problems, and left the hospital about 3-5 days sooner than those receiving standard care
  • What it means for you: If you or a loved one has a stroke and needs ICU care, asking whether the hospital uses coordinated feeding protocols may help ensure better nutrition support and potentially shorter hospital stays. However, this is one study from one hospital, so results may vary elsewhere

The Research Details

This was a retrospective cohort study, meaning researchers looked back at medical records of patients who had already been treated. They compared two groups: 47 patients who received routine nursing care and 36 patients who received a new coordinated nursing approach to feeding. To make the groups as similar as possible (so differences would be due to the care approach, not other factors), researchers used a statistical technique called propensity score matching, which resulted in 36 patients in each final group.

The coordinated care approach involved nurses following a structured plan for feeding patients through tubes into their stomachs. This included careful timing, monitoring for problems, and adjusting feeding based on how well patients tolerated it. Researchers measured nutrition blood markers (albumin, protein, prealbumin, and cholinesterase), tracked feeding goals, watched for stomach problems, and recorded how long patients stayed in the hospital.

This study design is considered moderately strong because it compares real-world patient outcomes, though it’s not as rigorous as a randomized controlled trial where patients are randomly assigned to groups.

The way nurses manage feeding in critically ill patients significantly affects recovery. Stroke patients in the ICU often can’t eat normally and need nutrition delivered through feeding tubes. If feeding isn’t managed carefully, patients can develop serious stomach problems that delay recovery. This study tests whether an organized, systematic approach works better than the usual approach, which is important for improving care practices.

Strengths: The study used propensity score matching to balance the groups, reducing bias. Researchers measured multiple important outcomes (nutrition, feeding tolerance, hospital stay). Limitations: This was a single-center study (one hospital), so results may not apply everywhere. It was retrospective (looking back at records) rather than prospective (following patients forward). The sample size was relatively small (83 total patients). The study was not randomized, so some unmeasured differences between groups could exist. Results need confirmation in larger, multi-center studies.

What the Results Show

Patients receiving coordinated nursing care showed significantly better nutrition markers compared to standard care. On days 3 and 7 of treatment, coordinated care patients had higher levels of albumin, total protein, prealbumin, and cholinesterase—all blood markers that indicate better nutritional status. The difference was statistically significant (P < .001, meaning there’s less than a 0.1% chance this happened by random chance).

The coordinated care group reached their feeding goals much faster and had higher success rates in meeting energy and protein targets (P < .01). This means patients were getting adequate nutrition sooner, which is important for healing.

Stomach problems were significantly reduced in the coordinated care group. Patients experienced fewer cases of gastric retention (food staying in the stomach too long), abdominal bloating, vomiting, and constipation (P < .05). Overall, 83.3% of coordinated care patients tolerated their feeding well, compared to only 61.1% in the standard care group.

Most importantly for hospital outcomes, patients in the coordinated care group spent significantly less time in both the ICU and the hospital overall (P < .01). This suggests they recovered faster and were ready to leave the hospital sooner.

Nutritional risk scores (measured by NRS2002) were significantly lower in the coordinated care group on days 7 and 14, indicating these patients were at lower nutritional risk as they progressed through their hospital stay. This suggests the coordinated approach not only improved nutrition but also reduced the overall risk of malnutrition complications. The improvement in gastrointestinal tolerance was particularly notable, as stomach problems are a common reason feeding must be interrupted in critically ill patients.

Previous research has shown that poor nutrition management in critically ill patients leads to worse outcomes, longer hospital stays, and more complications. This study aligns with that evidence and suggests that organized, systematic nursing approaches can significantly improve nutrition delivery. The findings support growing evidence that ‘bundled’ or ‘clustered’ interventions (combining multiple related care practices) tend to work better than individual interventions alone. However, most previous studies focused on general ICU patients, so this stroke-specific evidence adds valuable information.

This study has several important limitations. First, it was conducted at only one hospital, so results may not apply to other hospitals with different resources or patient populations. Second, it was retrospective, meaning researchers couldn’t control all variables as they could in a prospective study. Third, the sample size was relatively small (83 patients total), which limits how confident we can be in the results. Fourth, the study didn’t randomly assign patients to groups, so some unmeasured differences between groups could explain the results. Finally, we don’t know if these results would apply to stroke patients who are less critically ill or to other types of critically ill patients.

The Bottom Line

For ICU nurses and hospitals: Consider implementing coordinated, systematic nursing protocols for feeding critically ill stroke patients, as this approach appears to improve nutrition status and reduce hospital stay (Moderate confidence level—based on one well-designed study that needs confirmation). For patients and families: If a loved one is in the ICU after a stroke, ask the care team whether they use coordinated feeding protocols and what monitoring they do to ensure adequate nutrition (Low to Moderate confidence level—this is specialized ICU care that should be discussed with medical professionals).

This research is most relevant to: ICU nurses and nursing managers considering care protocol improvements; hospitals developing stroke care programs; physicians managing critically ill stroke patients; families of stroke patients in ICUs who want to understand nutrition management. This research is less relevant to: stroke patients who are not critically ill; patients who can eat normally; people without stroke.

In this study, benefits appeared quickly—within 3-7 days, nutrition markers improved. Patients reached feeding goals faster (exact timeline not specified but implied to be within the first week). Hospital stay reductions were measured in days to weeks. Realistic expectations: If this approach were implemented, you might expect to see improvements in nutrition status within the first week and potentially shorter overall hospital stays, though individual results vary.

Want to Apply This Research?

  • Track daily nutrition markers if available (albumin, protein levels from blood work), feeding goal achievement percentage, and gastrointestinal symptoms (bloating, constipation, vomiting). For caregivers: document daily feeding tolerance and any stomach-related issues to share with the medical team.
  • For healthcare providers using the app: Set daily reminders to follow the coordinated feeding protocol checklist. For patients/families: Use the app to log feeding tolerance observations and communicate them to the care team, ensuring the coordinated approach is being followed consistently.
  • Track nutrition blood work results weekly if available. Monitor gastrointestinal tolerance daily (rating 1-10). Record feeding goal achievement rates. Track ICU and hospital stay length. Set alerts for protocol adherence checkpoints. This creates accountability and helps identify if the coordinated approach is being implemented as intended.

This research describes specialized intensive care nutrition management for critically ill stroke patients. These findings apply to patients in ICU settings and should not be used to make decisions about nutrition for stroke patients outside the hospital or those who can eat normally. All nutrition and feeding decisions for critically ill patients should be made by the medical team caring for that specific patient. This study was conducted at one hospital and results may vary in different settings. Always consult with your healthcare provider before making any changes to medical care or nutrition plans. This information is educational and not a substitute for professional medical advice.