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住院患者肠内和肠外营养治疗质量指标的不遵守率很高。

High Frequency of Non-Compliance with Quality Indicators of Enteral and Parenteral Nutritional Therapy in Hospitalized Patients.

机构信息

School of Medicine, Federal University of Uberlândia, Uberlândia-MG 38.405-320, Brazil.

Management of Nutrition and Dietetics, Clinical Hospital of the Federal University of Uberlândia, Uberlândia-MG 38.405-320, Brazil.

出版信息

Nutrients. 2020 Aug 12;12(8):2408. doi: 10.3390/nu12082408.

DOI:10.3390/nu12082408
PMID:32806496
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7468971/
Abstract

Quality indicators in nutritional therapy (QINT) are measures of the effectiveness and quality of nutrition support. The purpose of this study was to evaluate the frequency of the QINT adequacy of Enteral Nutritional Therapy (EN) and/or Parenteral (PN) in hospitalized patients and identify the best indicators according to health professionals. A prospective study was performed, including data from patients aged 18 years or over admitted to clinical or surgical wards. The patients who had received EN and/or PN were followed from the first day of nutritional prescription until discharge. Twelve indicators were calculated, as recommended by the literature. Regarding professional opinion, the QINT adequacy was evaluated by observing its utility, simplicity, objectivity, and cost. Of the 727 hospitalized patients, 101 were on EN and/or PN. Regarding the 12 QINT evaluated, only 25% (3) achieved the goals: involuntary withdrawal of enteral feeding tube (0.01%); feeding tube occlusion or withdrawal per occlusion (0%); the measurement of energy and protein requirements (92%). A high frequency of non-compliance (75% of QINT) was observed in clinical and surgical patients on EN and/or PN. With knowledge of the six best indicators chosen by health professionals in this service, it will be possible to elaborate protocols according to the real-life situation in the institution.

摘要

营养治疗质量指标(QINT)是衡量营养支持有效性和质量的指标。本研究的目的是评估住院患者肠内营养治疗(EN)和/或肠外营养(PN)的 QINT 充足率,并根据卫生专业人员确定最佳指标。进行了一项前瞻性研究,纳入了年龄在 18 岁及以上、入住临床或外科病房的患者数据。从营养处方的第一天开始,对接受 EN 和/或 PN 的患者进行随访,直至出院。按照文献推荐,计算了 12 项指标。关于专业意见,通过观察 QINT 的实用性、简单性、客观性和成本来评估其充足性。在 727 名住院患者中,有 101 名接受了 EN 和/或 PN。在评估的 12 项 QINT 中,只有 25%(3 项)达到了目标:非自愿拔出肠内喂养管(0.01%);每发生一次堵管或拔出喂养管(0%);能量和蛋白质需求的测量(92%)。在接受 EN 和/或 PN 的临床和外科患者中,观察到 QINT 不达标率较高(75%)。了解该服务中卫生专业人员选择的六个最佳指标,将有可能根据机构的实际情况制定协议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b1/7468971/ad1687a6e47e/nutrients-12-02408-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b1/7468971/829991bb4037/nutrients-12-02408-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b1/7468971/a1d6a1e0f9c9/nutrients-12-02408-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b1/7468971/ad1687a6e47e/nutrients-12-02408-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b1/7468971/829991bb4037/nutrients-12-02408-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b1/7468971/a1d6a1e0f9c9/nutrients-12-02408-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b1/7468971/ad1687a6e47e/nutrients-12-02408-g003.jpg

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本文引用的文献

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Nutr Hosp. 2016 Sep 20;33(5):563. doi: 10.20960/nh.563.
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A.S.P.E.N. clinical guidelines: nutrition support of adult patients with hyperglycemia.美国肠外肠内营养学会临床指南:高血糖成人患者的营养支持。
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