Braun Benedikt, Grünewald Matthias, Adam-Paffrath Renate, Wesselborg Bärbel, Wilm Stefan, Schendel Lena, Hoenen Matthias, Müssig Karsten, Rotthoff Thomas
Heinrich-Heine-University Düsseldorf, Medical Faculty, Düsseldorf, Germany.
University Hospital Düsseldorf, Bildungszentrum, Düsseldorf, Germany.
GMS J Med Educ. 2019 Mar 15;36(2):Doc11. doi: 10.3205/zma001219. eCollection 2019.
Despite its frequency, malnutrition is underestimated in its importance for morbidity and mortality. Interprofessional nutrition management can improve patient safety and clinical outcomes. An interprofessional education is considered as the basis for good team cooperation. So far, little data is available on the effects of interprofessional education on measurable outcomes for patients. The objective is to determine to what extent student feedback leads to a change of in-patient nutritional management for a selected internal medical ward. In a teaching project based on the method of research oriented learning, medical and nursing students conducted an analysis of the nutritional situation of patients and developed individual treatment plans. The students orally reported their findings to the care teams as well as via a poster presentation to decision-makers of the clinic. A prospective cohort intervention study was conducted to assess the nutritional status of patients before and after student interventions using established screening tools. Differences were tested using t-test and Fisher's exact test. Institutional consequences for nutrition management were recorded descriptively. The teaching unit was evaluated by the students before and after. Malnutrition was found in 59% of patients. Inspired by student feedback, institutional consequences followed: a) routine inpatient screening using Nutritional Risk Screening; and b) the use of pie charts to estimate food intake. The feedback from the results of student interprofessional cooperation led to a sensitization of decision-makers and enabled new measures to improve nutritional management. These can increase patient safety.
尽管营养不良很常见,但其对发病率和死亡率的重要性却被低估了。跨专业营养管理可以提高患者安全性和临床结局。跨专业教育被视为良好团队合作的基础。到目前为止,关于跨专业教育对患者可测量结局的影响的数据很少。目的是确定学生反馈在多大程度上导致选定内科病房的住院营养管理发生变化。在一个基于研究性学习方法的教学项目中,医学和护理专业学生对患者的营养状况进行了分析,并制定了个性化治疗方案。学生们将他们的研究结果口头报告给护理团队,并通过海报展示报告给诊所的决策者。进行了一项前瞻性队列干预研究,使用既定的筛查工具评估学生干预前后患者的营养状况。使用t检验和费舍尔精确检验来检验差异。对营养管理的机构性后果进行了描述性记录。学生们在教学单元前后对其进行了评估。发现59%的患者存在营养不良。受学生反馈的启发,产生了以下机构性后果:a) 使用营养风险筛查进行常规住院患者筛查;b) 使用饼图估计食物摄入量。学生跨专业合作结果的反馈使决策者提高了认识,并促成了改善营养管理的新措施。这些措施可以提高患者安全性。