Enteral Feeding Intolerance in Adult Patients Receiving Mechanical Ventilation: A Comprehensive Review.

BACKGROUND: Enteral feeding intolerance, a type of gastrointestinal dysfunction, is common in adults receiving mechanical ventilation, yet its definition and clinical assessment remain variable. If untreated, this syndrome may lead to underfeeding, which is associated with worse patient outcomes. OBJECTIVE: To describe what is known about enteral feeding intolerance, including who is at risk, clinical symptoms, identifying measures used, treatment, and clinical implications for nursing practice. RESULTS: Enteral feeding intolerance is identified by (1) changes in gastrointestinal function, (2) high gastric residual volume, and/or (3) inadequate delivery of enteral nutrition. A combination of gastrointestinal symptoms and high gastric residual volume is generally used to diagnose the condition. The most common symptoms are vomiting, abdominal distention, absence of bowel sounds or flatus, and diarrhea. Administration of promotility agents and reduction of the enteral formula rate are most often used to reduce the effects of enteral feeding intolerance until it resolves. DISCUSSION: Many gastrointestinal assessment findings are subjective and lack precision. Although the routine measurement of gastric residual volume is no longer standard practice, it is indicated in patients at risk for enteral feeding intolerance. CONCLUSION: Nurses should become familiar with how to assess for and treat enteral feeding intolerance, as well as rule out other common gastrointestinal complications. Clinical biomarkers are needed to objectively identify enteral feeding intolerance in critically ill patients

Relationships Among Nursing Professional Development Department Processes and Publicly Reported Outcomes.

As hospital systems proliferate, research is needed to identify ideal nursing professional development (NPD) structures and processes to ensure optimal efficiencies and outcomes. Organizational participatory research was used to examine the level at which NPD processes are implemented and its relationships to publicly reported outcomes. Results indicated wide variability in NPD process implementation, many of which were significantly correlated with positive organizational and patient outcomes

Issue 17: Pulmonary & Critical Care Insider

Pulmonary & Critical Care Insider Issue 17 Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview. The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health. Topics:  Management of Uncomplicated Gram-Negative Bacteremia Complicated Urinary Tract Infection Guidelines Update Ketamine vs Etomidate for RSI STORM-PE  Lung Ultrasound–Guided Weaning  D-Dimer for Pulmonary Embolism Extubation Failure  A Multimodal, physiology-Driven approach to pleural effusions Dexmedetomidine for Hyperactive Delirium in the Non-Intubated ICU Patient Pulmonary Fibrosis and Sexual Health: The Quality-of-life Gap we rarely address High dose inhaled steroids in Asthma Hypernatremia in Adults, Dialysis in AKI Combination Therapy for OS

Association of Early Nutrition with Bronchopulmonary Dysplasia Severity and Magnetic Resonance Imaging Lung Characteristics in Preterm Infants.

INTRODUCTION: Restricted fetal and neonatal growth is a known risk factor for bronchopulmonary dysplasia (BPD) in premature infants. However, the impact of nutrition and infant growth specifically on lung growth in BPD is unknown. Moreover, whether all lung growth in BPD is beneficial is unclear. We hypothesized that lung growth and development and severity of BPD directly relate to caloric and protein intake, weight gain, and linear growth of premature neonates. METHODS: In this retrospective study, caloric and protein intake for the first 4 weeks of life, growth parameters along with lung volume, mass, density, and BPD severity obtained by ultrashort echo time (UTE) MRI, were analyzed. RESULTS: The cohort included 95 neonates with mean GA 26.1 weeks and BW 790 g. Infants with grade 2 and 3 BPD had less caloric and protein intake during first 4 weeks of life vs. grade 1 BPD (96/98 vs. 106 kcal/kg/day; 3.79/3.75 vs. 3.99 g protein/kg/day; p \u3c 0.05). UTE MRI showed that lung mass per body surface area increased with increasing BPD severity (237, 311, 384 g/m2 for grade 1, 2, and 3, respectively, p \u3c 0.05). Increased caloric intake was associated with decreased lung mass (p = 0.02) and improved BPD score on MRI (p = 0.04). CONCLUSION: Decreased nutritional intake during the first 4 weeks of life appears to be associated with more severe BPD, increased lung mass and more severe lung disease on MRI

Reducing Nursing Vacancy Through Practice Partnerships

A health system-based collaborative clinical partnership model was implemented to improve nursing students’ clinical experiences and recruit new nurse graduates into vacant nursing positions. A survey indicated clinical experiences with partnership instructors influenced student intent for employment post-graduation. Nurse vacancy decreased in correlation to new nurse graduate hires. A return on investment (ROI) analysis of the collaborative clinical partnership program estimated for 2023 an ROI of 680% with financial gain of 4.5 million dollars, and for mid-year 2024, the ROI was 408% with an estimated financial gain of 1.4 million dollars. Learning Objective: After completing this education activity, the learner will be able to discuss the correlation between nurse vacancy and new nurse graduate hires through a return on investment analysis

Issue 16: Pulmonary & Critical Care Insider

Pulmonary & Critical Care Insider Issue 16 Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview. The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health. Topics: EVERDAC Trial: Do All Shock Patients Need Arterial Lines? Beyond MAP: Redefining Perfusion Pressure in Septic Shock ECG Findings You Cannot Miss in Acute Pulmonary Embolism Food for Thought: When Private Equity Buys Hospitals, Who Pays the Price? Hemoglobin Targets in Acute MI: Is “Liberal” the New Normal? Choosing Wisely: Who Really Benefits from cEEG Monitoring? Lung Cancer Risks: What You Eat and Where You Live Really Matter! Penicillin Allergy: Worth Reassessing in the ICU Airway Registration Strategy and Efficiency in Shape-Sensing Robotic Bronchoscopy Battle of the Bronchoscopes: Ion vs Monarch vs Illumisite Maximum Lidocaine Dose in Pleural Procedures — Time to Rethink the Limits Beyond Tidal Volume: Rethinking Lung Protection in ARDS Alteplase for Acute Ischemic Stroke (4.5–24 Hour Window) PDE5 Inhibitors in ILD-Associated Pulmonary Hypertension — Only for the Severe

Parent and child attachment-like behaviors with conversational AI agents and perceptions of impact on family dynamics

Objective: We explored parents’ and children’s attachment-like behaviors with artificial intelligence (AI)-enabled smart speakers (often called digital assistants; DAs) and associations with perceived impacts on family dynamics. Background: DAs (e.g., Alexa) are increasingly integrated into homes, with prior research reporting varied uses, benefits, and concerns, including perceived emotional attachments among children. Method: We conducted an online survey of 351 parents who owned DAs to assess frequency of use, perception of positive/negative impacts, and attachment-like behaviors with DAs. Utilizing linear regression we examined associations between variables. Results: Approximately half reported at least daily DA use. Overall, participants reported moderate attachment-like behavior, with moderate positive impacts and low negative impacts; greater attachment-like behavior was positively associated with perceptions of both positive and negative impacts as well as frequency of use. Conclusion: Higher frequency of DA use and parents’ perceptions of impact—greater positive and greater negative—were associated with higher levels of attachment-like behavior. Implications: As DAs and generative AI become more advanced, human-AI relationships will likely become more complex, and continued research should assess their impact on families and child development. Full Report forthcomin

What bereaved people have found helpful following death of a loved one in a hospital: a survey study

Given the individual and public health impact of bereavement, discovering what people perceive as helpful after loss can improve interventions. In contrast to national projects, this project focused on two hospitals in a Midwestern hospital system. A survey was developed to assess the work of chaplains with next of kin following a death, to assess the awareness and helpfulness of persons and organizations in the community, and to ask what people had done, said, or given that was helpful, or what respondents wished people had done. From a list of 283 people invited to respond, 52 completed the survey. Survey responses indicated that chaplains were perceived as helpful in providing resources and support. Family and friends were the most used sources of support, RNs and physicians were the most helpful. Support from church sources was identified as helpful through unprompted responses. A theme identified as “remembering” emerged in several places, related to remembering the life and dates and stories about the deceased

2025 Parkview Research Repository Library Report - Infographic

A infographic compilation of data regarding readership and metrics of content in the Parkview Research Repository for the year of 2025. The platform, Digital Commons, is provided by Elsevier and the institutional repository is managed by the Parkview Research Library. This institutional repository (IR) was started in 2017 and is accessible worldwide

Operation Honor: Honoring our Veterans in the Medical Intensive Care Unit

Presented at the 2025 Parkview Nursing Research Symposium. A coworker had an impressionable conversation with a patient and their family regarding end of life. During this conversation she found out the patient was a veteran. This conversation made her aware of a care gap we could fill. She approached the NCAT chair to brainstorm ideas. After months of discussion and research, Operation Honor was born. Two goals of this project: 1)To honor veterans and their families To improve staff morale surrounding the loss of a patient as well as providing the patient with a “good death