Nutrition Support Teams: A Systematic Review

Abstract

BackgroundThe concept of a nutrition support team (NST) was first introduced at the end of the 20th century in the US and Europe. Expected benefits include reduced (inappropriate) prescription of (par)enteral nutrition; however, to the authors’ knowledge, no recent review has assessed the effectiveness of NSTs. Therefore, this systematic review evaluated the effectiveness of NSTs with respect to the prevalence of adult patients receiving (par)enteral nutrition.MethodsFive literature databases were searched and completed by citing searches. Studies on NSTs that were published between 2000 and 2018 in Western countries, applied a comparative design, and contained at least outcome data on the prevalence of (par)enteral nutrition were included. Analyses were mainly descriptive because of high heterogeneity that prevented meta‐analyses.ResultsThe 27 included studies mainly originated from the UK and US. Only 1 of the included studies was a randomized trial; the other studies had a pre‐post design (n = 17) or compared groups in a nonrandomized way. All but 2 studies were performed in acute care hospitals, and 5 studies focused only on intensive care patients. There was conflicting evidence of whether NSTs lead to reduction or increase in patients starting parenteral nutrition (PN); however, weak evidence suggested that NSTs might lead to an increase in the ratio of enteral nutrition to PN use and might decrease inappropriate PN use.ConclusionAlthough almost all studies concluded in favor of NSTs, the evidence base is weak and insufficient because of a lack of well‐designed studies and successful outcomes.

Risks in Management of Enteral Nutrition in Intensive Care Units: A Literature Review and Narrative Synthesis

“…A systematic review by Mistiaen et al (2020), stated, that there is weak evidence that Nutrition Support Teams increase appropriate EN use in ICU patients. A decrease of the duration of PN could not be shown [34].…”

Systematic review with meta‐analysis: effects of implementing a nutrition support team for in‐hospital parenteral nutrition

“…Previous systematic reviews primarily evaluated PN appropriateness and the enteral nutrition (EN) to PN trend 17,18 . These literature reviews found a decrease in inappropriate PN use and an increase in the EN to PN use ratio after NST introduction 17,18 .…”

“…Previous systematic reviews primarily evaluated PN appropriateness and the enteral nutrition (EN) to PN trend 17,18 . These literature reviews found a decrease in inappropriate PN use and an increase in the EN to PN use ratio after NST introduction 17,18 . Both reviews restricted eligible studies to those published after 2000 and neither performed meta‐analyses nor graded the evidence.…”

Ernährungsteams in hessischen Akutkrankenhäusern

“…Erschwerend kommen Schwankungen der Arbeitsbelastung in allen Aufgabenbereichen hinzu. Die unklare Zuordnung der Arbeitszeit zur Tätigkeit im Ernährungsteam zeigt sich auch in der Übersichtsarbeit von Mistiaen et al (2020), die Publikationen zu Ernährungsteams aus 11 Ländern auswerteten [10]. Damit hat sich die Situation, wie sie von Senkal bereits 2002 beschrieben wurde, offensichtlich nicht verbessert [15].…”