Puangco M A, Nguyen H L, Sheridan M J
Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030-6251, USA.
J Am Diet Assoc. 1997 Mar;97(3):258-61. doi: 10.1016/S0002-8223(97)00067-9.
To determine whether automation could accelerate the parenteral nutrition (PN) ordering and delivery process with concurrent improvements in the quality of nutrition therapy.
The time required to order, process, and deliver PN orders and specific nutrient composition of the PN solution were collected prospectively for 2 weeks on all neonatal intensive care unit (NICU) patients receiving PN during both the manual phase (before automation) and computer phase of the study.
SUBJECTS/SETTING: A total of 81 newborn infants in the NICU receiving PN for more than 5 days completed the study.
Student's unpaired t test was used to evaluate differences between computer and manual methods for all outcome variables of interest.
The time required to write and deliver PN orders was significantly lower using computer rather than manual methods (1.4 +/- 0.2 vs 4.5 +/- 0.5 minutes; P = .0001). Significant improvements in the nutrient composition of the PN solution resulted from use of computer ordering for energy (93.4 +/- 1.48 vs 79.2 +/- 1.8 kcal/kg per day; P = .0001), protein (2.92 +/- 0.02 vs 2.7 +/- 0.03 g protein per kilogram per day; P = .0001), calcium (2.3 +/- 0.1 vs 1.8 +/- 0.1 mEq/kg per day; P = .0005), and phosphate (1.3 +/- 0.06 vs 0.9 +/- 0.06 mM/kg per day; P = .0001). In addition, alkaline phosphatase levels improved (272 +/- 11 vs 404 +/- 25 U/L; P = .0001) and caloric and protein goals were achieved sooner (5.9 +/- 0.4 vs 8.7 +/- 0.8 days; P = .0045) when computer ordering rather than the manual method of ordering PN was used.
Our findings indicate that automating the process of writing and delivering PN orders saved time because it eliminated repetitive tasks and tedious calculations previously required of neonatologists, dietitians, and pharmacists. Patient care in our population of neonates was enhanced by improving the nutrient content of the PN solution.
确定自动化是否能加速肠外营养（PN）的下单和配送流程，同时提高营养治疗质量。
前瞻性收集在研究的人工阶段（自动化之前）和计算机阶段，所有接受PN的新生儿重症监护病房（NICU）患者的PN订单下单、处理和配送所需时间，以及PN溶液的具体营养成分，为期2周。
研究对象/地点：NICU中81名接受PN超过5天的新生儿完成了该研究。
采用学生独立样本t检验评估计算机方法和人工方法在所有感兴趣的结果变量上的差异。
使用计算机下单和配送PN订单所需时间显著低于人工方法（1.4±0.2分钟对4.5±0.5分钟；P = 0.0001）。使用计算机下单使PN溶液的营养成分有显著改善，包括能量（93.4±1.48千卡/千克·天对79.2±1.8千卡/千克·天；P = 0.0001）、蛋白质（2.92±0.02克蛋白质/千克·天对2.7±0.03克蛋白质/千克·天；P = 0.0001）、钙（2.3±0.1毫当量/千克·天对1.8±0.1毫当量/千克·天；P = 0.0005）和磷酸盐（1.3±0.06毫摩尔/千克·天对0.9±0.06毫摩尔/千克·天；P = 0.0001）。此外，与使用人工下单PN的方法相比，使用计算机下单时碱性磷酸酶水平有所改善（272±11对404±25 U/L；P = 0.0001），且热量和蛋白质目标更快实现（5.9±0.4天对8.7±0.8天；P = 0.0045）。
我们的研究结果表明，PN订单下单和配送流程自动化节省了时间，因为它消除了新生儿科医生、营养师和药剂师之前需要进行的重复性任务和繁琐计算。通过改善PN溶液的营养成分，我们所研究的新生儿群体的患者护理得到了加强。
