Analysis of the effect of clustered nursing interventions on enteral nutrition in critically ill stroke patients

This study aims to investigate the impact of clustered nursing interventions on the implementation of enteral nutrition (EN) in critically ill stroke patients and provide evidence for optimizing nutritional management in this patient population. This single-center retrospective cohort study included 83 critically ill stroke patients admitted to the intensive care unit (ICU) of our hospital from February 2023 to June 2024. Patients were divided into a routine care group (n = 47) and a clustered care group (n = 36) based on different nursing intervention strategies. To minimize confounding bias, propensity score matching was performed, and 36 patients were included in each group for final analysis. Nutritional indicators (albumin, total protein, prealbumin, cholinesterase), Nutritional Risk Screening 2002 (NRS2002), achievement of EN targets, gastrointestinal (GI) adverse events, GI tolerance, and short-term clinical outcomes (ICU stay and total hospital stay) were compared between the 2 groups. Baseline characteristics were balanced between the 2 groups after matching. Compared with the routine care group, the clustered care group showed significantly higher nutritional indicators (albumin, total protein, prealbumin, cholinesterase) on days 3 and 7 of intervention (P < .001); NRS2002 scores were significantly lower on days 7 and 14 (P < .001). The clustered care group achieved EN targets in a shorter time, with higher rates of energy and protein target attainment (P < .01). The incidence of GI adverse events such as gastric retention, abdominal distension, vomiting, and constipation was significantly reduced (P < .05), and GI tolerance was significantly better (83.3% vs 61.1%, P = .028). In terms of short-term outcomes, the clustered care group had significantly shorter ICU and total hospital stays (P < .01). Clustered nursing interventions can effectively improve nutritional status, enhance EN target attainment, improve GI tolerance, and shorten hospital stay in critically ill stroke patients. These findings support the clinical value of promoting such interventions in critical care nursing practice.