Monczka Jessica, Ayers Phil, Berger Mette M, Wischmeyer Paul E
Option Care Health, Denver, CO, USA.
Clinical Pharmacy Services, Department of Pharmacy, Baptist Medical Center, Jackson, MS, and University of Mississippi School of Pharmacy, Jackson, MS, USA.
Am J Health Syst Pharm. 2024 Jun 13;81(Supplement_3):S121-S136. doi: 10.1093/ajhp/zxae077.
This article is based on presentations and discussions held at the International Safety and Quality of Parenteral Nutrition (PN) Summit (held November 8-10, 2021, at Charleston, SC, and Bad Homburg, Germany) and aims to raise awareness concerning unresolved issues associated with the PN process and potential future directions, including a greater emphasis on patients' perspectives and the role of patient support.
Ensuring that every patient in need receives adequate PN support remains challenging. It is important to have a standardized approach to identify nutritional risk and requirements using validated nutritional screening and assessment tools. Gaps between optimal and actual clinical practices need to be identified and closed, and responsibilities in the nutrition support team clarified. Use of modern technology opens up opportunities to decrease workloads or liberate resources, allowing a more personalized care approach. Patient-centered care has gained in importance and is an emerging topic within clinical nutrition, in part because patients often have different priorities and concerns than healthcare professionals. Regular assessment of health-related quality of life, functional outcomes, and/or overall patient well-being should all be performed for PN patients. This will generate patient-centric data, which should be integrated into care plans. Finally, communication and patient education are prerequisites for patients' commitment to health and for fostering adherence to PN regimes.
Moving closer to optimal nutritional care requires input from healthcare professionals and patients. Patient-centered care and greater emphasis on patient perspectives and priorities within clinical nutrition are essential to help further improve clinical nutrition.
本文基于在国际肠外营养（PN）安全与质量峰会（于2021年11月8 - 10日在南卡罗来纳州查尔斯顿和德国巴特洪堡举行）上的演讲和讨论，旨在提高人们对与PN过程相关的未解决问题以及潜在未来方向的认识，包括更加强调患者的观点和患者支持的作用。
确保每一位有需求的患者都能获得充足的PN支持仍然具有挑战性。采用标准化方法，使用经过验证的营养筛查和评估工具来识别营养风险和需求非常重要。需要找出并弥合最佳临床实践与实际临床实践之间的差距，明确营养支持团队的职责。现代技术的应用为减轻工作量或释放资源提供了机会，从而能够采用更个性化的护理方法。以患者为中心的护理变得越来越重要，并且是临床营养领域中一个新兴的话题，部分原因是患者的优先事项和关注点往往与医疗保健专业人员不同。应该对PN患者定期进行与健康相关的生活质量、功能结局和/或患者总体幸福感的评估。这将生成以患者为中心的数据，这些数据应纳入护理计划。最后，沟通和患者教育是患者致力于健康以及促进对PN方案依从性的先决条件。
更接近最佳营养护理需要医疗保健专业人员和患者的参与。以患者为中心的护理以及在临床营养中更加强调患者的观点和优先事项对于进一步改善临床营养至关重要。
