School of Molecular Bioscience, University of Sydney, Sydney, New South Wales, Australia.
Department of Dietetics and Nutrition, Westmead Hospital, Sydney, New South Wales, Australia.
Nutr Diet. 2019 Feb;76(1):6-13. doi: 10.1111/1747-0080.12420. Epub 2018 Apr 6.
There is currently limited information regarding the home enteral nutrition population and its service practice at the state and national levels. The aim of this study is to report on patient numbers and demographics of the home enteral nutrition population in New South Wales, and to evaluate the implementation of home enteral nutrition services in public hospitals in the state.
A cross-sectional study was conducted using two online questionnaires, which were completed by the dietitian overseeing home enteral nutrition at each participating hospital.
The home enteral nutrition population of participating hospitals was approximately 7600, with 81% oral nutrition support patients and 19% tube-fed patients. Mean compliance score to the home enteral nutrition implementation checklist was 54.1% (±20.7%), with a range of 14.3% to 98.2%. Hospitals with a home enteral nutrition dietitian/coordinator scored a higher rate of compliance with the implementation checklist compared with hospitals without one (79.6% (±15.6%) vs 47.6% (±2.4%); P < 0.001). The key service improvements suggested by dietitians included increased funding towards a home enteral nutrition dietitian/coordinator (67.8%); improved resources to provide outpatient reviews, home visits and multidisciplinary service model (54.2%); improved database management and a more efficient registration process (52.5%).
Home enteral nutrition services continue to be inconsistent across New South Wales. Funding and resource limitations were identified as the major barriers to addressing gaps in service provision.
目前关于州和国家层面的家庭肠内营养人群及其服务实践的信息有限。本研究的目的是报告新南威尔士州家庭肠内营养人群的患者数量和人口统计学特征，并评估该州公立医院家庭肠内营养服务的实施情况。
采用横断面研究方法，使用两份在线问卷，由参与医院的营养师完成。
参与医院的家庭肠内营养人群约为 7600 人，其中 81%为口服营养支持患者，19%为管饲患者。家庭肠内营养实施清单的平均合规评分 54.1%（±20.7%），范围为 14.3%至 98.2%。有家庭肠内营养营养师/协调员的医院对实施清单的合规评分高于没有的医院（79.6%（±15.6%）比 47.6%（±2.4%）；P<0.001）。营养师建议的主要服务改进包括增加家庭肠内营养营养师/协调员的资金（67.8%）；改善提供门诊复查、家访和多学科服务模式的资源（54.2%）；改善数据库管理和更有效的注册流程（52.5%）。
新南威尔士州的家庭肠内营养服务仍然不一致。资金和资源限制被确定为解决服务提供差距的主要障碍。
