Implementation of Clinical Nutrition Practice Guidelines in Surgical ICUs

Summary

The goal of this interventional clinical trial is to evaluate whether the implementation of an evidence-based, context-adapted clinical nutrition practice guideline can improve clinical nutrition management in surgical intensive care units (ICUs) in China. The guideline is selected based on the best available evidence from existing surgical and critical care nutrition guidelines, adapted to the Chinese healthcare context, and implemented using an i-PARIHS-guided translation strategy. The trial involves ICU healthcare professionals working in surgical ICUs of tertiary general hospitals, while assessing nutrition-related clinical outcomes among surgical critically ill patients.

The main questions it aims to answer are:

Does guideline implementation improve ICU healthcare professionals' adherence to recommended clinical nutrition practice guidelines?

Does the implementation of the clinical nutrition practice guideline improve the proportion of surgical critically ill patients who achieve recommended energy and protein intake targets during ICU stay?

Researchers will compare outcomes before and after guideline implementation to determine whether the i-PARIHS-guided guideline translation improves nutrition management processes, healthcare professional performance, and patient-related clinical outcomes.

Participants will:

Complete baseline and post-implementation assessments related to clinical nutrition knowledge, attitudes, and practices.

Participate in guideline-based education, training, and implementation activities guided by the i-PARIHS framework.

Apply the adapted clinical nutrition practice guideline during routine clinical care in surgical ICUs.

Be evaluated through on-site audits, questionnaires, and clinical data collection during the implementation process.

Conditions

• ICU Patients
• Surgical
• Nutrition Intervention
• Enteral Nutrition
• Enteral Nutrition Intolerance

Interventions

BEHAVIORAL

Guideline Implementation

This behavioral intervention consists of the implementation of an evidence-based, context-adapted clinical nutrition practice guideline in surgical intensive care units (ICUs), guided by the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. The intervention includes systematic guideline selection based on existing surgical and critical care nutrition guidelines, contextual adaptation to the Chinese healthcare setting, guideline localization and expert consensus validation, and structured implementation strategies. Key components of the intervention include education and training of ICU healthcare professionals, on-site facilitation, audit and feedback, and continuous process optimization to support adherence to guideline recommendations. The intervention is delivered at the unit level and integrated into routine clinical practice in surgical ICUs. Outcomes are evaluated using a pre- and post-implementation design to assess changes in healt

Sponsors & Collaborators

• The Affiliated Hospital of Qingdao University

  collaborator OTHER

• Xuanwu Hospital, Beijing

  lead OTHER

Study Design

Allocation

NA

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-12-20

Primary Completion

2026-12-15

Completion

2026-12-31