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养老院中药房技术员对口服营养补充剂(ONS)的审查。

Pharmacy Technician Review of Oral Nutritional Supplements (ONS) within Care Homes.

作者信息

Collins Clare, Tucker Catherine, Walton Carol, Podbur Sian, Barrett Steven

机构信息

Pharmacy Department, Northumbria Healthcare NHS Foundation Trust, Rake Lane, Tyne & Wear, North Shields NE29 8NH, UK.

Dietetics Department, Northumbria Healthcare NHS Foundation Trust, Woodhorn Lane, Ashington NE63 9JJ, UK.

出版信息

Pharmacy (Basel). 2019 Mar 6;7(1):28. doi: 10.3390/pharmacy7010028.

Abstract

Up to 42% of patients admitted to care homes are at risk of malnutrition. Oral nutritional supplements (ONS) can be prescribed to increase nutritional intake when diet alone is insufficient to meet daily nutritional requirements. Where ONS are inappropriately initiated or continued beyond treatment goals this can contribute to significant waste and unnecessary costs. This study reviewed whether pharmacy technicians working in care home settings can support the cost-effective use of ONS. A quality improvement project using Plan-Do-Study-Act (PDSA) methodology was undertaken by pharmacy technicians working in care homes to review the prescribing and monitoring of ONS. A sample of 330 residents were reviewed across 5 care homes. 45 residents were prescribed ONS, 16 of whom were unknown to dietitians. In collaboration with the dietetic service an oral nutritional support flow chart was developed and tested. Thirteen of the 16 residents unknown to the dietetic team did not require ONS and could be considered for alternative dietary options. Through collaborative working with dietetic services, pharmacy technicians can support effective use and review of ONS for care home residents, reduce unnecessary prescribing, and ensure appropriate referral to dietitians where indicated.

摘要

入住养老院的患者中,高达42%存在营养不良风险。当仅靠饮食不足以满足每日营养需求时,可开具口服营养补充剂(ONS)以增加营养摄入。如果ONS的起始或持续使用不当,超出治疗目标,这可能会造成大量浪费并产生不必要的费用。本研究评估了在养老院工作的药剂师是否能支持ONS的成本效益使用。在养老院工作的药剂师采用计划-实施-研究-改进(PDSA)方法开展了一项质量改进项目,以评估ONS的处方和监测情况。对5家养老院的330名居民进行了抽样审查。45名居民被开具了ONS,其中16名营养师并不知晓。药剂师与营养科合作制定并测试了一份口服营养支持流程图。营养团队不了解的16名居民中,有13名不需要ONS,可考虑采用其他饮食选择。通过与营养科合作,药剂师可以支持对养老院居民有效使用和审查ONS,减少不必要的处方,并在必要时确保将患者适当转诊给营养师。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa54/6473454/cf3631c70a70/pharmacy-07-00028-g001.jpg

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