Indirect Calorimetry Access for Critical Need Populations through an Inter-Disciplinary Workflow

$25,000 Award

Project Overview

Over and underfeeding during periods of critical illness are associated with increased hospital length of stay, increased duration of mechanical ventilation, metabolic aberrations and infectious complications. Many populations served in the R Adams Cowley Shock Trauma Center are under-represented in literature validating predictive energy equations, and therefore access to timely indirect calorimetry (IC) studies is critical to optimizing the care of our patients. This innovation proposes a collaborative team-based workflow to successfully meet IC demand by increasing capacity from 3 to 10 or more studies weekly and reducing time to study availability from 7 days to no more than 3 days. Optimizing nutrition care in these populations will positively influence clinically relevant outcomes and improve patient safety.

Project Team

• Mary-Ann Purtill, MD – Physician Sponsor
• Rosemary Kozar, MD, PhD – Physician Sponsor
• Stacy Pelekhaty, MS, RD, LDN, CNSC – Process Owner
• Dino Gaetani, BSHA, RRT, RPFT – Process Facilitator
• Cheryl Epps, MS, RRT-ACCS – Process Facilitator
• Karen Riggin, RD, LDN, CNSC
• Chris Kircher, MS, RRT-ACCS
• Alison Winter-Lai, MS, RD, CSO, CDN

Midpoint Progress Updates – October 2023

The team has successfully obtained approval from the IRB to collect observational data generated from routine clinical care using the indirect calorimeter. Achievements to date include revising UMMC policies regarding in-patient indirect calorimetry, developing a procedural checklist for the indirect calorimeter and deploying it for use in the trauma critical care units with 2 trauma RD super-users. The calorimeter is currently being used for routine clinical care in mechanically ventilated patients, and the indirect calorimetry study data is being populated to a data collection database. The next focus is achieving the benchmarks of < 3 days from identification of study indication to study completion on all units, as well as conducting 10 weekly studies consistently.