Adherence to the national institute of clinical excellence guidance on parenteral nutrition screening is not enough to improve outcomes

Vincent, Royce P.; Omar, Sohail; Elnenaei, Manal O.; Goo, C. H.; Salota, Rashim; Wu, Pei-Fang; Delaney, Hannah; Roux, Carel W. le

doi:10.1016/j.clnu.2012.05.015

Cited by 5 publications

(5 citation statements)

References 22 publications

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“…There is a very lively discussion today about the CPG: which is the best methodology to outline CPG, 9 how to implement their spread within the target population, how to periodically check the adherence to the CPG by the potential users as well as whether this adherence actually leads to an improved outcome. 10 The main purpose of the present survey was to assess the level of compliance and satisfaction with the ESPEN CPG through the analysis of a small size sample of health professionals who replied to a structured questionnaire and, more important, to identify potential flaws of the present CPG and potential ways to improve quality of future guidelines.…”

Section: Discussionmentioning

confidence: 99%

Compliance of health professionals with the recommendations of the ESPEN Clinical Practice Guidelines: Results of ad hoc questionnaire

2014

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Background & aims: There is little information regarding the compliance of the ESPEN guidelines by health professionals. This survey aims to assess the compliance to these guidelines by the ESPEN members. Methods: Structured questionnaires were emailed to ESPEN members to collect information on: a) characteristics of the responders (demographic items, affiliations, practical/scientific involvement in clinical nutrition); b) satisfaction and compliance with grade A recommendations of 10 pathologic areas reported in the ESPEN guidelines; c) missing/poorly-represented issues; d) suggestions to improve the quality of future guidelines. Results: There were 131 responders (81% from Europe). Compliance in distinct pathologic areas was 77% on average and ranged from 66% (intensive care) to 85% (renal diseases). Surgery, intensive care and liver diseases had the higher number of disregarded recommendations and experts/specialists were somewhat more likely to disagree with them. Missing/underrepresented issues were more frequent in intensive care area followed by geriatrics. Half of responders would appreciate a second option, should the grade A recommendation be impossible to follow. Conclusion: ESPEN guidelines were generally well acknowledged by the users despite disagreement and dissatisfaction with a few of them. This survey provides the cue to complete/improve future guidelines and to address the research to more crucial issues. © 2013 European Society for Clinical Nutrition and Metabolism

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Section: Discussionmentioning

confidence: 99%

Compliance of health professionals with the recommendations of the ESPEN Clinical Practice Guidelines: Results of ad hoc questionnaire

2014

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“…Eight articles, [78][79][80][81][82][83][84][85] including 2 RCTs, 78,79 reported on topics of enteral nutrition (EN), parenteral nutrition (PN), perioperative nutrition, and nutrition support teams. Results showed that delirium and functional dependence predicted EN use in older patients but not the presence of malnutrition; those receiving EN had a higher proportion of death (41%) vs those fed orally (10%).…”

Section: Specialized Nutrition Carementioning

confidence: 99%

“…83 One study assessed immunonutrition with EN in malnourished patients undergoing elective surgery and did not find any effect on length of stay or infection rates. 78 In regard to PN, studies showed that the use of guidelines and decision trees for PN improved screening for malnutrition and targeting of PN to those who need it, 81,82 and strategies to optimize preoperative nutrition, including introduction of EN or PN, improved nutrition status and patient outcomes. 79,85 Subcutaneous PN may be useful in some older hospitalized patients.…”

Section: Specialized Nutrition Carementioning

confidence: 99%

Trends and Novel Research in Hospital Nutrition Care: A Narrative Review of Leading Clinical Nutrition Journals

Keller¹,

Laur

Dhaliwal

et al. 2020

J Parenter Enteral Nutr

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Hospital malnutrition is a longstanding problem that continues to be underrecognized and undertreated. The aim of this narrative review is to summarize novel, solution-focused, recent research or commentary to update providers on the prevention of iatrogenic malnutrition as well as the detection and treatment of hospital malnutrition. A narrative review was completed using the top 11 clinically relevant nutrition journals. Of the 13,850 articles and editorials published in these journals between 2013 and 2019, 511 were related to hospital malnutrition. A duplicate review was used to select (n = 108) and extract key findings from articles and editorials. Key criteria for selection were population of interest (adult hospital patients, no specific diagnostic group), solutionfocused, and novel perspectives. Articles were categorized (6 classified in >1 category) as Screening and Assessment (n = 17), Standard (n = 25), Advanced (n = 12) and Specialized Nutrition Care (n = 8), Transitions (n = 15), Multicomponent (n = 21), Education and Empowerment (n = 9), Economic Impact (n = 3), and Guidelines (n = 4) for summarizing. Research advances in screening implementation, standard nutrition care, transitions, and multicomponent interventions provide new strategies to consider for malnutrition prevention (iatrogenic), detection, and care. However, several areas requiring further research were identified. Specifically, larger and more rigorous studies that examine health outcomes and economic analyses are urgently needed.

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“…According to the Nutrition Guidelines for Adults, which was prepared by the National Institute for Clinical Excellence in 2006, it is recommended that energy intake should be slow and low so as to increase the weight in the range of 0.5-1 kg/week (13). However, the Guidelines for Treatment of Eating Disorders by the Psychiatric Association of Australia and New Zealand pointed out conflicting and insufficient findings in the literature in 2014 and recommended that the middle way should be followed.…”

Section: ) Parameters Requiring Follow-upmentioning

confidence: 99%

Refeeding Syndrome

KOCER¹,

GORMEZ²

2017

Bezmialem Science

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Refeeding syndrome (RFS) can be defined as a condition with severe electrolyte disturbance and metabolic abnormalities in undernourished patients who are undergoing refeeding. It is a life-threatening condition if not recognized or managed properly. Although there are no universally agreed guidelines on managing RFS, being aware of high-risk groups with close monitoring and a multidisciplinary approach is crucial for prevention as well as management. It is of paramount importance that clinicians are made more aware of this preventable, yet fatal, syndrome. There is also a great need for more randomized controlled trials to be performed, which can guide the clinical practice.

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Adherence to the national institute of clinical excellence guidance on parenteral nutrition screening is not enough to improve outcomes

Cited by 5 publications

References 22 publications

Compliance of health professionals with the recommendations of the ESPEN Clinical Practice Guidelines: Results of ad hoc questionnaire

Compliance of health professionals with the recommendations of the ESPEN Clinical Practice Guidelines: Results of ad hoc questionnaire

Trends and Novel Research in Hospital Nutrition Care: A Narrative Review of Leading Clinical Nutrition Journals

Refeeding Syndrome

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