This project addressed a critical aspect of TSICU care, looking at early and adequate EN. This project highlighted challenges in EN delivery in the TSICU, including delays in initiation and frequent feeding interruptions. Despite efforts to meet nutritional goals, some patients failed to reach optimal intake, often due to modifiable barriers. The findings support the need for implementation of a feeding protocol for EN initiation and a VBTF protocol for maximizing EN delivery once patients have reached their goal EN rate.