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Critical Care Nutrition at the Clinical Evaluation Research Unit (CERU)

is dedicated to improving nutrition therapies in the critically ill through knowledge generation, synthesis, and translation. We engage in a broad range of research activities and promote a culture of best practices in critical care nutrition. Ultimately, this will result in improved clinical outcomes for critically ill patients and increased efficiencies to our health care systems.

QI Tools

The resource center is a web-based toolkit intended to be used by critical care practitioners (e.g. dietitians, physicians, nurses, pharmacists) engaged in providing nutrition therapy to critically ill patients for quality improvement (QI) purposes.  The resource centre can be used to support the implementation of critical care nutrition guidelines or for self-development (i.e. to learn more about different aspect of nutrition therapy).

book-pagesBrowse tools by Resource Type: 

Bedside Tools


PEP uP Excel Daily Checklist

Creator: Naomi Cahill and Lauren Murch
Date: December 2010
Synopsis: An excel spreadsheet used to monitor the progress of enteral nutrition.  Automatically generates a graphical visual of the adequacy of nutrition delivered.

XLS


Adjusting Goal Feed Rates for Propofol

Creator: Jan Greenwood
Date: Summer 2010
Synopsis: This Bedside Tool outlines how and when to adjust feed rates to account for propofol in order to avoid overfeeding.

PDF


Nutrichu and Nutrichu User Guide

Creator: Jean-Charles Preiser
Date: Spring 2011
Synopsis: The purpose of the "NutriChu" software is to improve the nutritional therapy by adapting the prescription to the actual status of critically ill patients staying in intensive care units. "NutriChu" enables the calculation of the actual caloric and protein intakes, and the comparison with recommended targets (goals). The results are calculated automatically and displayed graphically. This software is the result of a close multi-disciplinary collaboration of different departments at the University Hospital of Liege (Belgium), and involved physicians; nurses, dieticians, pharmacists cooperating with Nutritional Team of the hospital.

XLS PDF


NUTRIC Score

Creator: Critical Care Nutrition
Date: March 19, 2013
Synopsis: This one-page information sheet outlines how to score and calculate the NUTRIC Score. The NUTRIC Score is designed to quantify the risk of critically ill patients developing adverse events that may be modified by aggressive nutrition therapy. The NUTRIC Score is built into the Bedside Nutrition Monitoring Tool, which you can access here.

PDFEnglish               PDFFrench                 PDF Portuguese

 


Care and Management of Nasoduodenal Feeding Tubes

Creator: Jan Greenwood
Date: 01/04/2010
Synopsis: This Bedside Tool includes information on securing nasoduodenal tubes, initiating and titrating feeds, prevention of aspiration, and other troublshooting tips related to post-pyloric feeding.

DOC PDF


Daily EN Checklist

Synopsis: This checklist for monitoring of EN helps determine if EN goals (to safely deliver >80% of calories daily) are being met, and if not, if appropriate startegies are being adopted (motility agents, small bowel feeds, etc) to achieve the highest possible EN adequacy.

PDF


EN Guideline for Surgical Procedures

Creator: Developed by: Dr Michael Meier, Adapted by: Dr John Drover
Date: Summer 2010
Synopsis: This guideline is meant to assist with the management of enteral feeding in critically ill patients that are going the operating room for a procedure. It outlines when to stop feeds prior to transfer to the operating room, and when/how to restart feeds upon the patient's return to the ICU.

DOC PDF


Gastric Feeding Algorithm

Creator: Jan Greenwood
Date: 01/04/2010
Synopsis: This Bedside Tool is a visual step-by-step guide to gastric feeding and managing high gastric residual volumes in the critically ill, where the goal is to safely deliver >80% of calories daily.

PDF PPT


Glycemic Control Protocol

Creator: KGH
Synopsis: This glycemic control protocol outlines frequency of monitoring blood glucose under various conditions, dosing and infusion rates for initiation of insulin therapy (when blood glucose is >9mmol/L) and dosing and infusion rates for continuation of insulin therapy.

doc_icon


Head of Bed Elevation Sticker

Date: 2009
Synopsis: These stickers are intended to be printed and placed on the patients feeding bag as a reminder to bed-side staff to elevate the head of the bed. The Head of Bed word or pdf files can be printed directly onto Avery 3-1/3"" x 4"" labels (compatible product codes are 5164, 5264, 5524, 8164, 8254, 8464, 48464, 55164, 58164, 48264).

DOC PDF JPG


ICU Guideline: Managing the Refeeding Syndrome

Creator: Jan Greenwood
Date: 01/04/2010
Synopsis: This Bedside Tool defines refeeding syndrome and provides information on monitoring patients at risk for refeeding syndrome, and adjusting the initiation and titration of feeds in those patients.

PDF PPT


Management of Diarrhea Algorithm

Creator: Jan Greenwood
Date: 01/04/2010
Synopsis: This algorithm is a visual step-by-step guide to management of diarrhea in the critically ill.

PDF PPT


Nasal/Oral Duodenal Feeding Tube Placement

Creator: Jan Greenwood
Date: Summer 2010
Synopsis: This pocket guide gives step by step information on placing post-pyloric feeding tubes. Also includes information on indications/contraindications, supplies needed and problem solving tips.

PDF


Nutrition Assessment checklist

Creator: Jan Greenwood
Date: Summer 2010
Synopsis: The Nutrition Assessment Checklist is a Bedside Tool designed to help dietitians identify patients who are at nutritional risk, to determine and record a nutrition care plan, and to make progress notes.

PDF


Parenteral Nutrition Algorithm

Creator: Jan Greenwood
Date: 01/04/2010
Synopsis: This algorithm is a visual step-by-step guide to use of PN in the critically ill.

PDF PPT


PN Preprinted Orders

Creator: KGH
Synopsis: This is a pre-printed order for provision of parenteral nutrition. It also includes guidelines for calculation of energy requirements.

PDF


QI Assessment Form

Creator: Jan Greenwood
Date: 01/04/2010
Synopsis: This bedside quality improvement tool is used to track nutrition prescribed, calories and protein received, as well as interruptions to delivery of enteral nutrition. Use one form per patient, with rows in the form representing days in ICU.

PDF


PEP uP Diarrhea Guideline

Creator: PEP uP Study Team
Date: December 2010
Synopsis: This reference sheet provides a guideline for potential causes of diarrhea and factors to consider in its management.. It was developed for use alongside the PEP uP Protocol.

PDF


Post-Pyloric Feeding Algorithm

Creator: Jan Greenwood
Date: Summer 2010
Synopsis: This Bedside Tool is a visual step-by-step guide to post-pyloric feeding in the critically ill. Includes information on initiation and advancement of post-pyloric feeds, and when post-pyloric feeding is and is not appropriate.

PDF PPT


Rapid Resource 1: Feeding Facts

Creator: Jan Greenwood
Date: Summer 2010
Synopsis: This pocket guide provides quick information on initiation, maintenance and termination of enteral nutrition.

PDF


Rapid Resource 2: TPN

Creator: Jan Greenwood
Date: 01/04/2010
Synopsis: This pocket guide gives information on determining energy requirements, calculating PN prescription, identifying and managing GI and metabolic complications.

PDF

Information Documents

 


 

The Right Approach to Nutrition Care in ICU Pamphlet

Creator: Judy King, Dr. Daren Heyland, Rupinder Dhaliwal
Date: February 18, 2014
Synopsis: This brochure outlines a process for incorporating the Canadian CPG, ASPEN/SCCM and ESPEN guidelines into a nutrition care plan for a critically ill patient. 

PDFDOC


Feeding Your Family Member in the ICU

Date: 08/02/2011
Synopsis: This document is targeted at patients' family members, and contains information about why nutrition therapy might be required, and types of nutrition therapy that may be provided. It suggests things family members can do to help with feeding their loved one, such as questions they should be prepared to answer (such as patient's height and usual weight, nutritional status) as well as some questions they should ask about their family member's nutrition in the ICU.

DOC


Routes of Nutrition Support Algorithm

Creator: Jan Greenwood
Date: 01/04/2010
Synopsis: This algorithm is a visual step-by-step guide to deciding what route of nutrition a patient should receive.

PDF PPT


Clinical Practice Guidelines Brochure

Date: 2009
Synopsis: This 4-page brochure developed in collaboration with Nestle Canada highlights key clinical practice guideline recommendations.

PDF


Rapid Resource 3: Tube Tips

Creator: Jan Greenwood
Date: Summer 2010
Synopsis: This pocket guide provides quick information on choosing a feeding route, placement method and type of tube. Also includes information on securing tubes and clearing occluded tubes.

PDF

Multimedia

 

 


 

Critical Care Nutrition course from Dietitians of Canada

Developer: Michele McCall, MSc, RD
Date: Spring 2011
Synopsis: The course is an intensive, evidence-based, self-learning program that provides health care practitioners the latest information on implementing nutrition care in the ICU. The program covers background information, nutrition research and practical information and is geared towards ICU nurses and dietitians. The course can be purchased here and is available to members and non-members of Dietitians of Canada.

Training Materials


Clinical Practice Guidelines Poster

Date: 2009
Synopsis: This poster developed in collaboration with Nestle Canada highlights key clinical practice guideline recommendations.

JPG


Clinical Practice Guidelines Screensaver

Date: 2009
Synopsis: The screensaver consists of a slideshow highlighting some of the key clinical practice guidelines e.g. early EN, use of feeding protocols, head of bed elevation. This messages are intended to be uploaded on to computers to act as remiders to bed-side staff.

ZIP JPG JPG JPG JPG


Interactive Workshop Assessment Handout

Synopsis: The Interactive Workshop Assessment Handout is a form that will enable you to collect feedback from your workshop, including what people learned and if/how they intend to change practices. Related tool: The Interactive Workshop Guide will help you plan and execute a workshop.

DOC


Interactive Workshop Guide

Synopsis: This is a step-by-step guide to conducting your own interactive workshop in your ICU, where the goal is to problem solve and identify strategies for improvement of nutrition practices. Related tool: The Interactive Workshop Assessment Handout will allow you to collect feedback from your workshop.

DOC


Pre-Printed Order

Date: 2009
Synopsis: This feeding protocol includes a pre-printed order and algorithm to guide the provision of enteral nutrition.

PDF JPG

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