Protected time for nutrition support teams: What are the benefits?

Ceniccola, Guilherme Duprat; Araújo, Wilma Maria Coelho; Brito-Ashurst, Ione de; Abreu, Henrique Barbosa de; Akutsu, Rita de Cássia Coelho de Almeida

doi:10.1016/j.clnesp.2016.08.002

Cited by 10 publications

(5 citation statements)

References 13 publications

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“…Com relação ao tempo disponibilizado aos profissionais para as atividades da EMTN, em um estudo recente com 7 hospitais públicos com mais de 250 leitos do Distrito Federal, todos os incluídos declararam possuir EMTN, mas em apenas 3 destes hospitais a EMTN dispunha de, no mínimo, uma hora semanal para suas atividades 19 . Neste estudo, os hospitais com horário de vigência garantido para, no mínimo, uma hora semanal com atividades da EMTN apresentaram melhor performance da equipe quando comparados aos hospitais sem esta vigência.…”

Section: Discussionunclassified

“…Apesar da clara recomendação da implementação de EMTN nos hospitais, não existe recomendação específica para tempo disponibilizado por cada profissional para atividades da equipe 19 Não houve número específico de hospitais públicos e privados de cada região, visto que o objetivo da pesquisa foi contemplar o máximo possível de instituições em todo o país. Foram incluídos todos os hospitais/profissionais de saúde presentes nas bases de dados disponíveis para o estudo (para isso foi utilizado os registros de email da BRASPEN).…”

Section: Introductionunclassified

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Quem Nutre? Uma pesquisa sobre as EMTNs do Brasil

Campos¹,

Ceniccola²,

Toledo³

et al. 2020

Braspen J

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Introduction: The excellence of Nutritional Therapy (NT) for hospitalized patients requires the existence of a Multiprofessional Nutrition Therapy Team (EMTN). The implementation of a EMTN in Brazilian hospitals is mandatory according to the National Health Surveillance Agency (ANVISA), since the publication of Ordinance 272 of 1998. The EMTN must be constituted by at least one doctor, one dietitian, one nurse and one pharmacist, qualified and with specific training in NT. Despite all efforts to develop NT in Brazil, the prevalence of malnutrition remains high. NT when performed by EMTN is associated with reduced complications and costs. The presence of EMTN still does not seem to be the reality of all Brazilian hospitals. Objective: The present study aims, by means of an electronic questionnaire, to determine the existence and the current situation of the EMTN in public and private hospitals in Brazil and to define the profile of the professionals who work in the EMTN. Methods: Study carried out using a survey-type electronic questionnaire. The REDCap program was used to record responses. Results: 115 Brazilian hospitals participated, of which 80% declared having EMTN, being present in all regions of the country, with greater prevalence in the Southeast region and in large hospitals. Regarding the use of NT, it was found that institutions with EMTN have a higher average use of Enteral NT (31.9 patients) and Parenteral NT (4.3 patients). There was also a greater use of oral supplements in hospitals with EMTN (37 patients) when compared to hospitals without EMTN (18.4 patients).In almost half of the institutions, work at EMTN is not the exclusive activity of these professionals. Conclusion: EMTN are not yet a reality in all large hospitals in Brazil. A broader study can help to clarify this scenario and propose strategies for the strengthening of NTMS and NT.

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Section: Discussionunclassified

Section: Introductionunclassified

Quem Nutre? Uma pesquisa sobre as EMTNs do Brasil

Campos¹,

Ceniccola²,

Toledo³

et al. 2020

Braspen J

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“…The value of a multidisciplinary team-based approach to the provision of nutrition support including PN is well established, with demonstrated benefits including improved adherence to evidence-based practice, improved clinical outcomes, and financial savings. 87,88 The clinician who initially enters a PN order, irrespective of the discipline (physician, nurse, dietitian, or pharmacist), is ultimately responsible for including orders for both MV and MTEs additives. Although regulations vary in geographic areas, in most countries a physician's order is required for PN.…”

Section: Rationalementioning

confidence: 99%

Parenteral Provision of Micronutrients to Adult Patients: An Expert Consensus Paper

Blaauw

Osland

Ali

et al. 2019

Journal of Parenteral and Enteral Nutrition

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Background Micronutrients, an umbrella term used to collectively describe vitamins and trace elements, are essential components of nutrition. Those requiring alternative forms of nutrition support are dependent on the prescribed nutrition regimen for their micronutrient provision. The purpose of this paper is to assist clinicians to bridge the gap between the available guidelines’ recommendations and their practical application in the provision of micronutrients via the parenteral route to adult patients. Methods Based on the available evidenced‐based literature and existing guidelines, a panel of multidisciplinary healthcare professionals with significant experience in the provision of parenteral nutrition (PN) and intravenous micronutrients developed this international consensus paper. Results The paper addresses 14 clinically relevant questions regarding the importance and use of micronutrients in various clinical conditions. Practical orientation on how micronutrients should be prescribed, administered, and monitored is provided. Conclusion Micronutrients are a critical component to nutrition provision and PN provided without them pose a considerable risk to nutrition status. Obstacles to their daily provision—including voluntary omission, partial provision, and supply issues—must be overcome to allow safe and responsible nutrition practice.

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“…In subsequent years, the NST concept was widely accepted, and the number of NSTs blossomed in a variety of structures (eg, teams, groups, and committees) in various healthcare organizations (eg, acute, long‐term acute care, and rehabilitation hospitals) in the United States 2–8 . Over the past five decades, NSTs have evolved owing to lessons learned, innovations in technology and practices, changes in healthcare financing, and more recently, a pandemic 9–30 …”

Section: Introductionmentioning

confidence: 99%

Nutrition support teams: Institution, evolution, and innovation

et al. 2022

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The historical institution, evolution, and innovations of nutrition support teams (NSTs) over the past six decades are presented. Focused aspects of the transition to transdisciplinary and patient‐centered care, NST membership, leadership, and the future of NSTs are further discussed. NSTs were instituted to address the need for the safe implementation and management of parenteral nutrition, developed in the late 1960s, which requires the expertise of individuals working collaboratively in a multidisciplinary fashion. In 1976, the American Society for Parenteral and Enteral Nutrition (ASPEN) was established using the multidisciplinary model. In 1983, the United States established the inpatient prospective payment system with associated diagnosis‐related groupings, which altered the provision of nutrition support in hospitals with funded NSTs. The number of funded NSTs has waxed and waned since; yet hospitals and healthcare have adapted, as additional education and experience grew, primarily through ASPEN's efforts. Nutrition support was not administered in some instances by the “core of four” (physician, nurse, dietitian, pharmacist). The functions may be carried out by a member of the core of four not associated with the parent discipline, in accordance with licensure/privileging. This cross‐functioning has evolved into the adaptation of the concept of transdisciplinarity, emphasizing function over form, supported and enhanced by “top‐of‐license” practice. In some institutions, nutrition support has been incorporated into other healthcare teams. Future innovations will assist NSTs in providing the right nutrition support for the right patient in the right way at the right time, recognizing that nutrition care is a human right.

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Protected time for nutrition support teams: What are the benefits?

Cited by 10 publications

References 13 publications

Quem Nutre? Uma pesquisa sobre as EMTNs do Brasil

Quem Nutre? Uma pesquisa sobre as EMTNs do Brasil

Parenteral Provision of Micronutrients to Adult Patients: An Expert Consensus Paper

Nutrition support teams: Institution, evolution, and innovation

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