When implementing early enteral nutrition in critically ill patients, which factor is most likely to increase success in moving toward the target feeding rate?

• A. Degree of adherence to physician's orders
• B. Combined use of EN and PN
• C. Use of gastric feeding
• D. Use of an interdisciplinary EN feeding protocol

Answer: (D)

Using an interdisciplinary EN feeding protocol brings together physicians, nurses, dietitians, and pharmacists to implement a consistent plan for advancing feeding rates. The protocol defines when to start EN, how and when to increase the rate, and how to respond to signs of intolerance or interruptions. This coordinated approach reduces delays caused by miscommunication, ensures tolerance is monitored and addressed promptly, and creates predictable progress toward the target rate. While following physician orders is important, and gastric feeds are common, neither by itself guarantees rapid advancement without a clear protocol. Combining EN with PN is used when EN alone cannot meet needs, but it does not inherently accelerate reaching the target EN rate.