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Nutrition continues to be a concern for the older adult in the intensive care setting despite widespread knowledge of the benefits of adequate nutrition and existing evidence-based protocols. The incidence of malnutrition in hospitalized patients ranges between 22% and 43% with the highest probability of occurrence, 50% or more, in the intensive care unit patient. The deleterious effects of malnutrition for the critically ill older adult are described with suggested and accepted screening tools for existing or acquired malnutrition. A discussion of early oral and enteral feeding interventions and strategies for overcoming barriers is explored. Enteral feeding complications are delineated, and perceived barriers or risks are disputed. This paper concludes with suggestions for future research and a definitive role for advanced nursing nutrition champions. [ABSTRACT FROM AUTHOR]

The article discusses the implementation of a collaborative approach to the use of oxytocin during labor. The three areas that form the basis of a collaborative approach to oxytocin management are multidisciplinary input and consensus, clinical understanding of physiology and research, and physiological appropriate dosage and titration.