An evaluation of intensive care nurses' performance of indirect calorimetry measurements

BackgroundIndirect calorimetry (IC) is the gold standard to monitor energy expenditure in critically ill patients. In several intensive care units (ICUs), nurses are responsible for carrying out the measurements.AimThe aim of this study was to assess nurses' perception of their involvement in IC.Study designThis was a prospective survey conducted in the surgical ICU of a French university hospital after 18 months of use of the Q-NRG + (R) calorimeter (COSMED (c), Italy). All nurses who have used the calorimeter in the previous 6 months in this ICU were questioned through a questionnaire about their theoretical and practical knowledge and experience in using it.ResultsThe participation rate was 93% (28/30 surveyed). All the respondents understood the objectives of performing an IC and 23 of them (82%) had used the device at least once in the previous 6 months. All the users thought it was pertinent that ICU nurses were in charge of the IC measurements, 16 of them (70%) reported having been formally trained, mostly by a colleague, and 17 (77%) felt comfortable with the device after 2 to 5 uses. The five non-users (8%) did not have the opportunity to do so. Theoretical and practical knowledge could be improved as only 5 of the users (22%) declared to know the main criteria of reliability of the IC measurement and 4 of them (18%) declared to know the maintenance and cleaning protocol of the device.ConclusionNurses quickly felt comfortable with the Q-NRG + (R) in this ICU. Formal initial and ongoing training of all staff completing IC is essential to perform IC measurements safely and to obtain reliable and interpretable results in practice.Relevance to Clinical PracticeInvolving the nursing team in nutritional care, even if it is technical, seems to bring satisfaction in terms of overall patient care.