Traditionally, monitoring of the gastric residual volume (GRV) in tube-fed patients is performed to assess feeding tolerance and to prevent aspiration pneumonia.
The self-administered questionnaire included questions about their practice of GRV checks, such as frequency, time spent, documentation, adherence to physician orders, and their perception of high GRV (Table).
While all the nurses answered that they managed patients with tube feeds and checked GRV in all their patients, surprisingly, their responses on other critical questions varied widely.
Since, according to the nurses, orders for GRV checks were not there most of the time, not surprisingly there was a wide variation of nurses' perception of "high GRV" ranging from 100 mL to 200 mL.
The use of GRV as a tool for assessing the tolerance of enteral feeds has been included in many nutritional support algorithms in critical care units.
Mentec et al (17) reported that too frequent GRV checks may lead to frequent holding of the feeds causing decrease in the volume of diet absorbed.
While all the study participants documented the details of GRV checks in some form, the majority of the nurses in our study preferred paper documentation.
The GRV is mounted on a heavy-duty chassis to facilitate rapid transport from gate to gate.
The GRV is a great piece of equipment, but when at capacity, we have to offload.
In maximum recovery mode the GRV can fill its onboard tank in as little as 3.5 minutes, so the pilot program found something had to be done to speed truck cycling.
"Our contractor came up with an innovative solution in which one of two fluid transfer vehicles are summoned when the GRV tank is two-thirds full.
"Dulles has addressed the issue early and vigorously," said Bill Munn, GRV product manager, Federal Signal Corporation, Environmental Products Group.