Nutrition Administration and Ventilator Weaning in Long-Term Acute Care

Ernest Health, which includes Northern Colorado Long Term Acute Hospital, recently was recognized nationally for its work in nutrition management and administration for patients being weaned from ventilators in its long-term acute care hospitals (LTACHs).

The initiative, which was introduced and led by Cindy Tew, Ernest Health’s Director of Clinical Programs and Resources, and Anne Woodbury, Registered Dietitian Nutritionist at Utah Valley Specialty Hospital, won the 2017 Quality Achievement Award from the National Association of Long Term Hospitals.

“We wanted to see if we could track specific nutritional indicators that could positively influence patients being weaned from ventilators,” Tew says. In particular, the team wanted to find if the level of protein provided to a ventilated patient had any effect on the success of weaning the patient off the ventilator.

“Mechanical ventilation is a life-saving procedure that’s used to support patients who are recovering from critical illnesses or injuries,” Woodbury explains. “Patients who require prolonged mechanical ventilation need specialized medical assistance in healing and weaning from ventilator dependence, and nutrition plays a critical role in this.”

A team of Ernest Health dietitians led by Tew and Woodbury created a nutritional tracking form to collect data from its LTACH hospitals to monitor tube feeding tolerance and nutrition administration. That data was collected from patients who had been on a ventilator longer than 96 hours and were in respiratory failure.

After two years of collecting data from 204 patients, the team found more successful ventilator weaning results when a patient could tolerate 1.6-2.0 grams of protein each day.

“Data of this nature has never been recorded before, so we’re optimistic about the potential impact of our findings,” Tew says. “These are promising results not only for our patients, but for other post-acute hospitals to consider for their patients as well.”

Ernest Health’s LTACH hospitals will continue to collect data and measure protein intake values to substantiate significance with a larger data pool of patients being weaned from ventilators. The intent is to publish the results in the future for other post-acute hospitals to consider.