Enteral Nutrition Administration Record (ENAR) Prescribing Process Using Computerized Order Entry: A New Paradigm and Opportunities to Improve Outcomes in the Critically Ill.

BACKGROUND: Prevalence of malnutrition has been reported in 60% of hospitalized and up to 78% patients admitted to intensive care units (ICUs). Malnutrition has been associated with complications such as infection, increased hospital length of stay, morbidity, and mortality. Nutritional support has been shown to reduce avoidable readmissions, pressure ulcers, malpractice claims, and hospital costs. Creating a new Electronic Nutrition Administration Record (ENAR) with a linked nutrition tab within the Electronic Health Record (EHR) would promote enhanced patient outcomes by improving adherence to established institutional enteral nutrition (EN) protocols and achieving early caloric goals. Additionally, it would enable a clear and standardized method for documentation and administration of EN therapy. MATERIALS AND METHODS: A multidisciplinary nutrition improvement team was established and convened weekly to evaluate current practices, identify stakeholders, discuss strategies and barriers to ENAR implementation, and to establish process and workflow guidelines. The aim of this manuscript is to describe a systematic approach and the process of creating a new ENAR with a linked nutrition tab in the EHR and illustrate order panel built and lessons learned from the process. CONCLUSION: A separate nutrition tab was created in the EHR with minimal disruption in patient care and end-users positive feedback for the new order panel. ENAR allows for easier data collection and promotes nutrition related research that may result in enhanced patient care. Utilizing technology to build a full electronic nutrition administration record would result in optimized patient care and safety. This article is protected by copyright. All rights reserved.