Implementation of Clinical Nutrition Practice Guidelines in Surgical ICUs
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorXuanwu Hospital, Beijing
About this trial
The goal of this interventional clinical trial is to evaluate whether the implementation of an evidence-based, context-adapted clinical nutrition practice guideline can improve clinical nutrition management in surgical intensive care units (ICUs) in China. The guideline is selected based on the best available evidence from existing surgical and critical care nutrition guidelines, adapted to the Chinese healthcare context, and implemented using an i-PARIHS-guided translation strategy. The trial involves ICU healthcare professionals working in surgical ICUs of tertiary general hospitals, while assessing nutrition-related clinical outcomes among surgical critically ill patients.
The main questions it aims to answer are:
Does guideline implementation improve ICU healthcare professionals' adherence to recommended clinical nutrition practice guidelines?
Does the implementation of the clinical nutrition practice guideline improve the proportion of surgical critically ill patients who achieve recommended energy and protein intake targets during ICU stay?
Researchers will compare outcomes before and after guideline implementation to determine whether the i-PARIHS-guided guideline translation improves nutrition management processes, healthcare professional performance, and patient-related clinical outcomes.
Participants will:
Complete baseline and post-implementation assessments related to clinical nutrition knowledge, attitudes, and practices.
Participate in guideline-based education, training, and implementation activities guided by the i-PARIHS framework.
Apply the adapted clinical nutrition practice guideline during routine clinical care in surgical ICUs.
Be evaluated through on-site audits, questionnaires, and clinical data collection during the implementation process.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
None
Disqualifiers
None
Trial design
Design model
Single group
Treatments tested in this trial
Guideline Implementation
BehavioralThis behavioral intervention consists of the implementation of an evidence-based, context-adapted clinical nutrition practice guideline in surgical intensive care units (ICUs), guided by the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. The intervention includes systematic guideline selection based on existing surgical and critical care nutrition guidelines, contextual adaptation to the Chinese healthcare setting, guideline localization and expert consensus validation, and structured implementation strategies. Key components of the intervention include education and training of ICU healthcare professionals, on-site facilitation, audit and feedback, and continuous process optimization to support adherence to guideline recommendations. The intervention is delivered at the unit level and integrated into routine clinical practice in surgical ICUs. Outcomes are evaluated using a pre- and post-implementation design to assess changes in healt
Treatment groups
200 Participants
are divided into 1 treatment groupGroup A: Guideline Implementation GroupExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Adherence of ICU Healthcare Professionals to Clinical Nutrition Practice Guidelines
Adherence of ICU healthcare professionals to clinical nutrition practice guidelines, assessed using structured audit tools based on key guideline recommendations, including nutrition assessment, initiation and delivery of nutrition support, monitoring, and documentation practices.
Time frame
At baseline (prior to implementation) and at 6 months after implementation.Secondary outcomes
1
Proportion of Surgical Critically Ill Patients Achieving Energy and Protein Intake Targets During ICU Stay
The proportion of surgical critically ill patients whose actual daily energy and protein intake meets guideline-recommended targets during ICU stay. Energy and protein intake will be calculated based on prescribed targets and recorded enteral and/or parenteral nutrition delivery. Patients achieving both energy and protein targets will be considered as meeting the outcome.
Time frame
From ICU admission (Day 1) to ICU dischargeOther outcomes
1
Time to Initiation of Enteral Nutrition After ICU Admission
Time from ICU admission to the initiation of enteral nutrition, measured in hours, based on medical records and nutrition orders.
Time frame
From ICU admission (Day 1) to initiation of enteral nutrition (up to 7 days).2
Frequency of Enteral Nutrition Interruptions During ICU Stay
Number of enteral nutrition interruption events per patient during ICU stay, including interruptions due to procedures, intolerance, or clinical decisions, as documented in medical and nursing records.
Time frame
From ICU admission (Day 1) to ICU discharge3
GLIM Classification
Nutritional status at ICU admission and ICU discharge assessed using the Global Leadership Initiative on Malnutrition (GLIM) criteria, categorized according to standard GLIM diagnostic classifications.
Time frame
At ICU admission (Day 1) and ICU discharge4
Cumulative energy balance during ICU stay
Cumulative energy balance was calculated as the sum of the daily differences between delivered energy intake and prescribed energy targets during the ICU stay.
Time frame
From ICU admission (Day 1) to ICU dischargeLocations
Sponsors and contacts
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Xuanwu Hospital, Beijing
Lead sponsor
The Affiliated Hospital of Qingdao University
Collaborator
Source ClinicalTrials.gov
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