Constructing the early enteral nutrition management protocol for severely burned adult patients: a Delphi study

BACKGROUND: Early enteral nutrition (EEN) plays a crucial role in the treatment of severely burned adult patients. However, its clinical implementation remains inconsistent and lacks standardization, which may hinder optimal rehabilitation outcomes of severely burned adult patients. This study aims to create a standardized EEN management protocol specifically tailored for severely burned adult patients. METHODS: An initial draft of the EEN management protocol for severely burned adult patients was formulated through a comprehensive literature review and discussions within an expert panel. This was followed by a two-round Delphi study, in which 17 professional experts from eight provinces and municipalities evaluated the importance and feasibility of the protocol’s items using the structured questionnaire. Based on the feedback received from each round of experts, revisions were made to the protocol’s items. RESULTS: After two rounds of Delphi consultation, 17 experts converged to a consensus. The EEN management protocol for severely burned adult patients included 5 first-level items, organizational management, comprehensive assessment, nutritional intervention, outcome monitoring, and quality control, with 23 second-level items and 66 third-level items. The expert authority coefficient of consultation was 0.924 and 0.919, respectively. In the first round of expert consultation, the Kendall coefficient of concordance (Kendall’s W) for the importance and feasibility of the items was 0.156 and 0.128, respectively (P < 0.001). In the second round of expert consultation, Kendall’s W for the importance and feasibility of the items was 0.142 and 0.122, respectively (P < 0.001). CONCLUSIONS: This Delphi-derived protocol standardizes EEN management for severely burned adult patients by integrating evidence, expert insights, and operational practicality. It serves as a valuable reference for clinical medical staff for providing high-quality nutrition services.