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<article xsi:noNamespaceSchemaLocation="http://jats.nlm.nih.gov/publishing/1.1/xsd/JATS-journalpublishing1-mathml3.xsd" dtd-version="1.1" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"><front><journal-meta><journal-id journal-id-type="publisher-id">JCNR</journal-id><journal-title-group><journal-title>Journal of Clinical and Nursing Research</journal-title></journal-title-group><issn>2208-3685</issn><eissn>2208-3693</eissn><publisher><publisher-name>Bio-Byword Scientific Publishing Pty. Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.26689/jcnr.v10i5.14673</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title>Nurse-Led Early Enteral Nutrition Tolerance Management Protocol for Patients with Severe Traumatic Brain Injury: A Quasi-Experimental Study</title><url>https://artdesignp.com/journal/JCNR/10/5/10.26689/jcnr.v10i5.14673</url><author>GuoXiuping,LiHaiju,TaoYu,WangLi</author><pub-date pub-type="publication-year"><year>2026</year></pub-date><volume>10</volume><issue>5</issue><history><date date-type="pub"><published-time>2026-05-31</published-time></date></history><abstract>Objective: To evaluate the efficacy of a nurse-led early enteral nutrition (EN) tolerance management protocol in reducing feeding intolerance and improving nutritional outcomes among patients with severe traumatic brain injury (STBI). Methods: A total of 128 STBI patients admitted to the neurosurgical intensive care unit between June 2024 and June 2025 were enrolled. The control group &amp;nbsp;received conventional EN care from June to December 2024, while the intervention group &amp;nbsp;received the nurse-led protocol from January to June 2025. The primary outcomes were feeding intolerance incidence, target caloric achievement rate on day 4, nocturnal feeding prevalence, and ICU length of stay. Results: The incidence of feeding intolerance was significantly lower in the intervention group compared to the control group . The intervention group demonstrated higher target caloric achievement rates on day 4 &amp;nbsp;and day 7 . Nocturnal feeding was significantly reduced , and ICU length of stay was shorter .Conclusion: The nurse-led early EN tolerance management protocol effectively reduces feeding intolerance, enhances early nutritional adequacy, minimizes nocturnal feeding disruptions, and shortens ICU stay for STBI patients.</abstract><keywords/></article-meta></front><body/><back><ref-list><ref id="B1" content-type="article"><label>1</label><element-citation publication-type="journal"><p>Chinese Society of Neurosurgery, 2022, Chinese Expert Consensus on Early Rehabilitation Management of Severe Traumatic Brain Injury (2022 Edition). Chin J Neurosurg, 38(6): 541–551.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B2" content-type="article"><label>2</label><element-citation publication-type="journal"><p>Li L, Wang X, Li C, 2020, Research Progress on Early Enteral Nutrition Support in Patients with Severe Traumatic Brain Injury. Chin J Nurs, 55(3): 456–460.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B3" content-type="article"><label>3</label><element-citation publication-type="journal"><p>McClave S, Taylor B, Martindale R, et al., 2016, Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: SCCM and A.S.P.E.N. JPEN J Parenter Enteral Nutr, 40(2): 159–211.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B4" content-type="article"><label>4</label><element-citation publication-type="journal"><p>Reintam Blaser A, Starkopf J, Alhazzani W, et al., 2017, Early Enteral Nutrition in Critically Ill Patients: ESICM Clinical Practice Guidelines. Intensive Care Med, 43(3): 380–398.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B5" content-type="article"><label>5</label><element-citation publication-type="journal"><p>Zhang Y, Yang L, Wang X, 2019, Meta-analysis of Risk Factors for Enteral Nutrition Feeding Intolerance in ICU Patients. Chin Nurs Manag, 19(8): 1181–1187.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B6" content-type="article"><label>6</label><element-citation publication-type="journal"><p>Xu L, Li Q, Han B, 2021, Application of Nurse-led Nutrition Support Management Model in ICU Patients. J Nurs Sci, 36(12): 97–100.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B7" content-type="article"><label>7</label><element-citation publication-type="journal"><p>Padar M, Uusvel G, Starkopf J, et al., 2019, Implementation of a Nurse-driven Enteral Nutrition Protocol in an Intensive Care Unit: A Before-and-after Study. J Clin Nurs, 28(23–24): 4384–4392.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B8" content-type="article"><label>8</label><element-citation publication-type="journal"><p>Zhou M, Zhang C, Tian Y, 2020, Development and Validation of a Feeding Intolerance Assessment Scale for Critically Ill Patients. Chin Crit Care Med, 32(9): 1097–1101.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B9" content-type="article"><label>9</label><element-citation publication-type="journal"><p>Reintam Blaser A, Malbrain M, Starkopf J, et al., 2012, Gastrointestinal Function in Intensive Care Patients: Terminology, Definitions and Management. Recommendations of the ESICM Working Group on Abdominal Problems. Intensive Care Med, 38(3): 384–394.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B10" content-type="article"><label>10</label><element-citation publication-type="journal"><p>Liu F, Zhao H, Sun J, 2022, Application of Nurse-led Enteral Nutrition Tolerance Management in Neurocritical Patients. Chin J Pract Nurs, 38(15): 1145–1150.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B11" content-type="article"><label>11</label><element-citation publication-type="journal"><p>Wang Z, Zhang L, Chen W, et al., 2021, A Nurse-led Enteral Nutrition Tolerance Management Protocol for Critically Ill Patients: A Quasi-experimental Study. J Adv Nurs, 77(8): 3426–3435.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B12" content-type="article"><label>12</label><element-citation publication-type="journal"><p>Chen L, Wang F, Li P, 2020, Research Progress on Gastrointestinal Dysmotility Mechanism and Nursing Intervention in Severe Traumatic Brain Injury Patients. J Nurses Train, 35(14): 1276–1279.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B13" content-type="article"><label>13</label><element-citation publication-type="journal"><p>Sun Q, Wang X, 2019, Application Progress of Short-peptide Enteral Nutrition Formulations in Critically Ill Patients. Parenter Enteral Nutr, 26(5): 311–314.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B14" content-type="article"><label>14</label><element-citation publication-type="journal"><p>Yang X, Wu G, 2018, Biological Rhythms and Enteral Nutrition: From Basic to Clinical. Chin J Gastrointest Surg, 21(12): 1428–1432.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B15" content-type="article"><label>15</label><element-citation publication-type="journal"><p>Wei X, Day A, Ouellette D, et al., 2019, The Association Between Nutritional Adequacy and 28-day Mortality in the Critically Ill. Crit Care, 23(1): 323.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B16" content-type="article"><label>16</label><element-citation publication-type="journal"><p>Zhang H, Li L, Wang Y, 2020, Effect of Early Enteral Nutrition on Prognosis of Severe Traumatic Brain Injury Patients. Chin J Trauma, 36(5): 432–437.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B17" content-type="article"><label>17</label><element-citation publication-type="journal"><p>Voigt R, Forsyth C, Keshavarzian A, 2019, Circadian Rhythms: A Regulator of Gastrointestinal Health and Dysfunction. Expert Rev Gastroenterol Hepatol, 13(5): 411–424.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B18" content-type="article"><label>18</label><element-citation publication-type="journal"><p>Heyland D, Stephens K, Day A, et al., 2011, The Success of Enteral Nutrition and ICU-acquired Infections: A Multicenter Observational Study. Clin Nutr, 30(2): 148–155.</p><pub-id pub-id-type="doi"/></element-citation></ref></ref-list></back></article>
