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医院肠内营养质量控制审核工具的开发。

Development of a tool for quality control audits in hospital enteral nutrition.

作者信息

Duprat Ceniccola Guilherme, Coelho Araújo Wilma Maria, Akutsu Rita

机构信息

Universidade de Brasilia-UnB. Departamento de Nutrição..

出版信息

Nutr Hosp. 2014 Jan 1;29(1):102-20. doi: 10.3305/nh.2014.29.1.7071.

Abstract

BACKGROUND AND AIMS

Malnutrition is very prevalent in hospitals, causing physical capacity deterioration, increasing complications and raising mortality. This scenario overloads public health costs enormously. Enteral nutrition (EN) is the first option to fight against malnutrition. Nutrition support teams (NST) work combating such conditions, promoting humanization, but also analyzing the cost benefit of EN therapy. Brazil is one of the first Latin American countries to develop EN laws. Quality control it is in the core of this legal instrument, playing an essential role in NST`s task of providing care. Nowadays, tools to access quality control represent a gap in the area. The aim of this study was to develop a quality control tool, according to Brazilian law for EN Therapy regarding multidisciplinary approach, good practices, standard operating procedures, protocol implementation, proper registration and electronic health record.

METHODS

A content validation method was utilized in this four stages development process: bibliographic research, expert opinion (subjective), semantic evaluation and expert opinion (objective). In the latter stage ten specialists, expressed their opinion, evaluating the tools by four different attributes: utility, simplicity, objective and low cost on a 5-point Likert scale (1-5).

RESULTS

We elaborate three independent tools that together, represent the whole evaluation process, named: NST Activities, EN Preparation and EN Administration. Content Validation Index to the four different attributes ranged form 0,9 to 1.

CONCLUSION

This tool had positive approval from experts and is of great value guiding hospital audits, or even serving as checklist to implement a plan on EN therapy.

摘要

背景与目的

营养不良在医院中极为普遍,会导致身体机能衰退、并发症增加以及死亡率上升。这种情况给公共卫生成本带来了巨大负担。肠内营养(EN)是对抗营养不良的首选方法。营养支持团队(NST)致力于应对此类状况,促进人性化护理,同时分析EN治疗的成本效益。巴西是最早制定EN相关法律的拉丁美洲国家之一。质量控制是该法律文书的核心内容,在NST提供护理的工作中发挥着至关重要的作用。如今,获取质量控制的工具在该领域存在空白。本研究的目的是根据巴西关于EN治疗的法律,开发一种涵盖多学科方法、良好实践、标准操作程序、方案实施、正确记录和电子健康记录的质量控制工具。

方法

在这个分四个阶段的开发过程中采用了内容验证方法:文献研究、专家意见(主观)、语义评估和专家意见(客观)。在最后一个阶段,十位专家发表了他们的意见,通过五点李克特量表(1 - 5)从实用性、简易性、客观性和低成本四个不同属性对工具进行评估。

结果

我们精心设计了三个独立的工具,它们共同代表了整个评估过程,分别命名为:NST活动、EN准备和EN管理。四个不同属性的内容验证指数范围为0.9至1。

结论

该工具得到了专家的积极认可,对于指导医院审计具有重要价值,甚至可作为实施EN治疗计划的检查表。

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