Oxford Radcliffe Hospitals NHS Trust, Pharmacy Department, Churchill Hospital, Oxford OX3 7LJ, UK.
Proc Nutr Soc. 2011 Aug;70(3):285-92. doi: 10.1017/S0029665111000541.
Professor Pennington was an advocate for quality in all aspects of nutrition support and its delivery, ensuring that the patient remained at the centre of all decisions, and that specialist artificial nutrition support was best managed by the multidisciplinary nutrition team and the education of the wider healthcare community. Within the conference theme of 'Quality', this commentary aims to outline drivers for and risks to aspects of quality in parenteral nutrition (PN) services. Quality is defined as a particular property or attribute associated with excellence; in the context of the provision of PN this can be translated to quality processes and standards in the assessment, prescription, preparation, administration and monitoring of PN. Quality products and services are delivered through the timely application of knowledge, competence, procedures and standards. Quality can be so easily compromised; inattention, ignorance and arrogance all play their part. PN is a high-risk therapy; the quality of its delivery should not be entirely dependent on the skills, knowledge and competence of those delivering this care but on accepted standards, procedures, communication, resource and infrastructure. Identification of key steps in the provision of PN and a review of the relevant patient safety data reveal points where safeguards can be put in place to ensure quality is not compromised. Full evaluation of standardisation, computerisation and competency-based training as risk-reduction strategies is required.
彭宁顿教授是全面营养支持及其实施质量的倡导者，他确保患者始终是所有决策的核心，并确保由多学科营养团队和更广泛的医疗保健社区来管理专业的人工营养支持。在本次会议的“质量”主题中，本篇述评旨在概述肠外营养（PN）服务质量的驱动因素和风险。质量被定义为与卓越相关的特定属性或特征；在提供 PN 的背景下，这可以转化为评估、处方、准备、管理和监测 PN 时的质量流程和标准。优质的产品和服务是通过及时应用知识、能力、程序和标准来提供的。质量很容易受到影响；注意力不集中、无知和傲慢都会产生影响。PN 是一种高风险的治疗方法；其提供的质量不应完全依赖于提供这种护理的人员的技能、知识和能力，而应依赖于公认的标准、程序、沟通、资源和基础设施。确定提供 PN 的关键步骤并审查相关的患者安全数据，可以发现可以采取哪些保障措施来确保质量不受影响。需要充分评估标准化、计算机化和基于能力的培训作为降低风险的策略。
