{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:53:27Z","timestamp":1784264007152,"version":"3.55.0"},"reference-count":13,"publisher":"AACN Publishing","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Routine gastric residual volume monitoring remains common in nursing practice. However, current evidence supports using a focused nursing assessment to identify signs and symptoms of enteral feeding intolerance such as abdominal pain, abdominal distension, and vomiting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Local Problem<\/jats:title>\n                  <jats:p>At the author\u2019s institution, nurses and other clinicians began reporting inconsistencies in gastric residual volume monitoring along with frequent interruptions in the delivery of enteral nutrition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>The quality improvement project included patients in the medical intensive care unit receiving enteral nutrition. Gastric residual volume monitoring was eliminated. Instead, enteral nutrition was suspended on the basis of signs and symptoms of enteral feeding intolerance. Multimodal education was provided to nurses, nurse practitioners, and physicians caring for these patients. Formative evaluation occurred via staff rounds, summative evaluation occurred through a staff survey, and nutritional adequacy was evaluated by tracking patient weight.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The 6-week project included 37 patients on the medical intensive care unit service. Of these patients, 28 gained weight; the mean change in weight was +6.2%. The practice change was well perceived by staff and is now an established part of care for any patient receiving enteral feedings at the study hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The deimplementation of routine gastric residual volume monitoring is supported by evidence. Use of a focused gastrointestinal nursing assessment to identify enteral feeding intolerance is safe, feasible, and effective and improves nutrition delivery and nurses\u2019 workflow.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4037\/ccn2024937","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:11:31Z","timestamp":1706746291000},"page":"34-44","source":"Crossref","is-referenced-by-count":4,"title":["Deimplementation of Gastric Residual Volume Monitoring to Enhance Patient Nutrition"],"prefix":"10.4037","volume":"44","author":[{"given":"Hannah E.","family":"Landgrave","sequence":"first","affiliation":[{"name":"Hannah E. Landgrave is an assistant professor at the Moffett and Sanders School of Nursing, Samford University, Birmingham, Alabama, and a critical care nurse in the medical intensive care unit, UAB Hospital, Birmingham."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"issue":"3","key":"2024020100112704500_b1-0440034","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1038\/ajg.2016.28","article-title":"ACG clinical guideline: nutrition therapy in the adult hospitalized patient","volume":"111","author":"McClave","year":"2016","journal-title":"Am J Gastroenterol"},{"key":"2024020100112704500_b2-0440034","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s40560-019-0371-7","article-title":"Strategies for optimal calorie administration in critically ill patients","volume":"7","author":"Yatabe","year":"2019","journal-title":"J Intensive Care"},{"issue":"1","key":"2024020100112704500_b3-0440034","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1097\/ccm.0000000000004712","article-title":"Incidence, risk factors, and clinical consequence of enteral feeding intolerance in the mechanically ventilated critically ill: an analysis of a multicenter, multiyear database","volume":"49","author":"Heyland","year":"2021","journal-title":"Crit Care Med"},{"issue":"1","key":"2024020100112704500_b4-0440034","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1177\/0884533614562841","article-title":"Gastric residual volume in critically ill patients: a dead marker or still alive?","volume":"30","author":"Elke","year":"2015","journal-title":"Nutr Clin Pract"},{"issue":"2","key":"2024020100112704500_b5-0440034","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1097\/CCM.0000000000001525","article-title":"Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)","volume":"44","author":"Taylor","year":"2016","journal-title":"Crit Care Med"},{"issue":"2","key":"2024020100112704500_b6-0440034","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.aucc.2018.12.001","article-title":"The impact of removing gastric residual volume monitoring and enteral nutrition rate titration in adults receiving mechanical ventilation","volume":"33","author":"Wiese","year":"2020","journal-title":"Aust Crit Care"},{"key":"2024020100112704500_b7-0440034","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.ijnurstu.2018.11.005","article-title":"Effects of not monitoring gastric residual volume in intensive care patients: a meta-analysis","volume":"91","author":"Wang","year":"2019","journal-title":"Int J Nurs Stud"},{"issue":"3","key":"2024020100112704500_b8-0440034","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1002\/ncp.10442","article-title":"Elimination of routine gastric residual volume monitoring improves patient outcomes in adult critically ill patients in a community hospital setting","volume":"35","author":"Bruen","year":"2020","journal-title":"Nutr Clin Pract"},{"issue":"3","key":"2024020100112704500_b9-0440034","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1001\/jama.2012.196377","article-title":"Effects of not monitoring gastric residual volume on risk of ventilator-associated pneumonia in adults receiving mechanical ventilation and early enteral feeding: a randomized controlled trial","volume":"309","author":"Reignier","year":"2013","journal-title":"JAMA"},{"issue":"3","key":"2024020100112704500_b10-0440034","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1177\/0148607112440285","article-title":"Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition)","volume":"36","author":"White","year":"2012","journal-title":"JPEN J Parenter Enteral Nutr"},{"key":"2024020100112704500_b11-0440034","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.jcrc.2016.01.028","article-title":"Evaluation of the effect on patient parameters of not monitoring gastric residual volume in intensive care patients on a mechanical ventilator receiving enteral feeding: a randomized clinical trial","volume":"33","author":"Ozen","year":"2016","journal-title":"J Crit Care"},{"key":"2024020100112704500_b12-0440034","unstructured":"Seres\u2008D\n          . Nutrition support in critically ill patients: enteral nutrition. Upto-Date. Updated March 8, 2021. Accessed July 2, 2022. https:\/\/www.uptodate.com\/contents\/nutrition-support-in-critically-ill-patients-enteral-nutrition"},{"key":"2024020100112704500_b13-0440034","unstructured":"American Association of Critical-Care Nurses\n          . AACN Levels of Evidence. 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