P205 Quality Control Indicators in Enteral Nutrition: The Compliance Rates in a General Hospital in Brazil

Martins, José Carlos Amado; Horie, L.M.; Shiroma, Glaucia Midori; Ortolani, Maria C.; Logullo, L.; Bittencourt, Amanda F.; Hafez, V.C.B.; Waitzberg, D.L.

doi:10.1016/s1744-1161(09)70255-8

Cited by 4 publications

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“…8 However, in addition to the scarcity of available human and material resources, the application of the 36 QINTs to clinical practice has been hindered by the high number of QINTs proposed. 9 To enable the effective application of QINTs, we believe that ease of application and objectivity must be considered in addition to other factors. 10,11 An excessive number of QINTs must be avoided because they may be difficult to apply 262 Nutrition in Clinical Practice 27 (2) in clinical practice, whereas the determination of a feasible number of QINTs could be practically applicable and contribute to the success of quality control in NT.…”

Section: Clinical Researchmentioning

confidence: 99%

Selection of Top 10 Quality Indicators for Nutrition Therapy

et al. 2012

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Nutrition therapy (NT) is important to correct protein-energy malnutrition and can help to prevent many adverse outcomes, including increased infection complication rate, impaired wound healing, longer length of hospital stay, higher treatment costs, and increased mortality.1 However, NT is not without attendant risks and adverse effects and is oriented by procedures that were systematically developed based on important scientific publications in the area and the consensual opinions of experts. 2-5One way to control protocol compliance would be through the routine practice of periodic nutrition quality control to identify possible difficulties and failures related to the application of protocols during nutrition care provided to the patient. 6,7 Therefore, in addition to the effort to develop nutrition guidelines, it is also necessary to design quality indicators in nutrition therapy (QINTs) that control the correct application of these guidelines in NT.The available guidelines comprise an elevated number of recommendations to be followed and could consequently lead to the design of an elevated number of QINTs.3-5 In 2008, the task force of clinical nutrition of the International Life Science Institute-Brazil (ILSI-Brazil) published a list of 36 QINTs and their respective national goals proposed by consensus by a group of 41 Brazilian NT specialists to attend different issues regarding national and international NT guidelines. 8 However, in addition to the scarcity of available human and material resources, the application of the 36 QINTs to clinical practice has been hindered by the high number of QINTs proposed. 9To enable the effective application of QINTs, we believe that ease of application and objectivity must be considered in addition to other factors.10,11 An excessive number of QINTs must be avoided because they may be difficult to apply Selection of Top 10 Quality Indicators for Nutrition TherapyCristiane Comeron Gimenez Verotti, RD; Raquel Susana Matos de Miranda Torrinhas, MB; Ivan Cecconello, MD, PhD; and Dan Linetzky Waitzberg, MD, PhD AbstractBackground: The identification of useful quality indicators for nutrition therapy (QINTs) is of great interest and a challenge. This study attempted to identify the 10 QINTs that best suit the practice of quality control in nutrition therapy (NT) by evaluating the opinion of experts in NT with the use of psychometric techniques and statistical tools. Methods: Thirty-six QINTs available for clinical application in Brazil were assessed in 2 distinct phases. In phase 1, 26 nutrition experts ranked QINTs by scoring 4 attributes (utility, simplicity, objectivity, low cost) to assess each QINT on a 5-point Likert scale. The top 10 QINTs were identified from the 10 best scores obtained, and the reliability of expert opinion for each indicator was assessed by Cronbach's α. In phase 2, experts provided feedback regarding the selected top 10 QINTs by answering 2 closed questions. Results: The top 10 QINTs, in descending order, are the frequency of nutrition screening o...

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Section: Clinical Researchmentioning

confidence: 99%

Selection of Top 10 Quality Indicators for Nutrition Therapy

et al. 2012

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“…Even when considering these obstacles, the QINT II that evaluated the frequency of estimated energetic and proteic expenditure for patients under NT met the goal established at > 80% in all three years of study, which reiterates the MNTT efforts to individualize NT. Martins et al (27), in a prospective study with 200 patients and Oliveira Filho et al (28) in a retrospective study with 551 ward and ICU cancer patients, also found > 80% of adequacy in the same QINT. With the intention of define the energy needs for the severely ill patients, the indirect calorimetry is the golden standard.…”

Section: Quality Indicators For Enteral and Parenteral Nutrition Thermentioning

confidence: 82%

“…One the other hand, the values in 2010 (10.5%) and 2012 (10.7%) were bordering the target established. Bittencourt et al (41), in an observational study with 110 patients, applied the diarrhea indicator and found a prevalence of 13%, while Martins et al (27) met 8%. In the literature, there are records with higher percentages of episodes of diarrhea, with values ranging from 14% to 41% of the days on ENT (41).…”

Section: Quality Indicators For Enteral and Parenteral Nutrition Thermentioning

confidence: 99%

Quality indicators for enteral and parenteral nutrition therapy: application in critically ill patients "at nutritional risk"

Filho¹

2016

Nutr Hosp

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Palabras clave:Indicadores de calidad. Nutrición enteral. Nutrición parenteral. Paciente crítico. Malnutrición. ResumenIntroducción: los indicadores de calidad en terapia nutricional (ICTN) permiten evaluar la calidad de la terapia nutricional (TN) de forma práctica. Objetivo: implementar y monitorizar los ICTN en pacientes críticos con riesgo nutricional. Métodos: estudio transversal con pacientes críticos > 18 años en riesgo nutricional, en terapia nutricional enteral (TNE) o parenteral (TNP) exclusiva a > 72 horas. Después de 3 años consecutivos, 9 ICTN fueron implementados y monitorizados. El análisis estadístico fue realizado con el software SPSS, versión 17.0. Resultados: fueron incluidos 145 pacientes, siendo 93 en TNE, 65% eran de sexo masculino, con edad promedio de 55,7 años (± 17,4); 52 pacientes que estaban en TNP, 67% eran de sexo masculino, con edad promedio de 58,1 años (± 17,4). Todos los pacientes (TNE y TNP) fueron cribados en la admisión, los cálculos de las necesidades calóricas y proteínicas fueron individualizados. Apenas la TNE fue precoz, > 70% del volumen prescrito fue administrado y fue visto una reducida pérdida de la sonda nasoenteral. Las frecuencias de diarrea y ayuno digestivo no fueron adecuadas en TNE. La administración adecuada de energía fue contemplada apenas en TNP y hubo una signifi cativa tendencia de recuperación en la vía oral en TNE. Conclusión: después de 3 años de estudio, el porcentaje de adecuación de los ICTN varió entre 55%-77% para TNE y 60%-80% para TNP. Los resultados refl ejan los esfuerzos del equipo multiprofesional de TN en mantener la calidad de la asistencia nutricional en los pacientes críticos con riesgo nutricional. AbstractIntroduction: Quality Indicators for Nutritional Therapy (QINT) allow a practical assessment of nutritional therapy (NT) quality. Objective: To apply and monitor QINT for critically ill patients at nutritional risk. Methods: Cross sectional study including critically ill patients > 18 years old, at nutritional risk, on exclusive enteral (ENT) or parenteral nutritional therapy (PNT) for > 72 hours. After three consecutive years, 9 QINT were applied and monitored. Statistical analysis was performed with SPSS version 17.0. Results: A total of 145 patients were included, 93 patients were receiving ENT, among then 65% were male and the mean age was 55.7 years (± 17.4); 52 patients were receiving PNT, 67% were male and the mean age was 58.1 years (± 17.4). All patients (ENT and PNT) were nutritionally screened at admission and their energy and protein needs were individually estimated. Only ENT was early initiated, more than 70% of the prescribed ENT volume was infused and there was a reduced withdrawal of enteral feeding tube. The frequency of diarrhea episodes and digestive fasting were not adequate in ENT patients. The proper supply of energy was contemplated only for PNT patients and there was an expressive rate of oral intake recovery in ENT patients. Conclusion: After three years of research, the percentage of QINT adequacy varied be...

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“…Does this reflect the real world faced every day by the nutrition practitioner? After all, obtaining even simple, basic measurements like patients' body weight can be a challenge in the daily routine if the hospital has no bed scales 4 …”

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confidence: 99%

A Difference Must Make a Difference

Waitzberg

2010

J Parenter Enteral Nutr

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P205 Quality Control Indicators in Enteral Nutrition: The Compliance Rates in a General Hospital in Brazil

Cited by 4 publications

References 0 publications

Selection of Top 10 Quality Indicators for Nutrition Therapy

Selection of Top 10 Quality Indicators for Nutrition Therapy

Quality indicators for enteral and parenteral nutrition therapy: application in critically ill patients "at nutritional risk"

A Difference Must Make a Difference

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