The effects of the administration of oral nutritional supplementation with medication rounds on the achievement of nutritional goals: A randomized controlled trial

Berg, G; Lindeboom, Robert; Zwet, W.C. van der

doi:10.1016/j.clnu.2014.04.011

Cited by 18 publications

(18 citation statements)

References 19 publications

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“…Reducing the volume of ONS during medication rounds increased the compliance of patients needing ONS [33]. In the present study, over 80% of over-the-counter ONS were Maibalance ® .…”

Section: Discussionmentioning

confidence: 60%

Adherences to oral nutritional supplementation among hospital outpatients: An online cross-sectional survey in Japan

et al. 2019

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Oral nutritional supplements (ONS) are multi-nutrient products used to increase the energy and nutrient intakes of patients. The aim of this study was to examine whether or not the adherence of patients varies according to their receiving prescription or over-the-counter ONS. Data were obtained from an online cross-sectional survey conducted with patients in Japan. A total of 107 patients who matched the inclusion criteria for the prescription ONS group and 148 who matched the criteria for the over-the-counter ONS group were further analyzed. In the prescription and over-the-counter ONS groups, the main medical reason for ONS consumption were “malnutrition” (48 patients [44.9%] vs. 63 patients [42.6%] p = 0.798], “frailty” (29 patients [27.1%] vs. 36 patients [24.3%] p = 0.663) and “aging” (25 patients [23.4%] vs. 30 patients [20.3%] p = 0.644). The proportion of “No particular disease” for prescription ONS consumption was significantly lower than that for over-the-counter ONS (6 patients [5.6%] vs. 24 patients [16.2%] p = 0.001). The body mass index of the prescription ONS group was significantly higher than that of the over-the-counter ONS group (21.1±4.38 kg/m2 vs. 19.9±3.75 kg/m2, p = 0.0161). In the prescription ONS group, all patients were given medical advice by doctors or registered dietitians. In contrast, in the over-the-counter ONS group, only 46 patients (31.1%) were given advice by doctors or registered dietitians (p<0.001). In the prescription ONS group, ONS was taken significantly more times and for a longer duration than in the over-the-counter ONS group (p<0.0001). However, among patients given advice by doctors or registered dietitians, there were no significant differences between the groups. Greater support by the medical team is still needed in order to maximize adherence to supplementation, especially concerning the calories, timing and period, so that benefits can be achieved and sustained.

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“…Reducing the volume of ONS during medication rounds increased the compliance of patients needing ONS [33]. In the present study, over 80% of over-the-counter ONS were Maibalance ® .…”

Section: Discussionmentioning

confidence: 60%

Adherences to oral nutritional supplementation among hospital outpatients: An online cross-sectional survey in Japan

et al. 2019

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“…48 Inadequate administration and documentation of nutrition therapies, including ONS, has been found to be a significant problem in hospitals and has been identified as a barrier in the implementation and evaluation of nutritional care and prevention of pressure injuries. 25,27,49,50 In fact, in many hospitals, nutrition therapies are often documented as volume-only in the intake No difference between anthropometrical measurements, biochemical parameters, and nutritional intake pre-and poststudy. Wound area did not decrease significantly in the short term for both groups.…”

Section: Optimizing Nutrition Monitoringmentioning

confidence: 99%

“…25,49,50 Solutions that allow for standardized ordering, administration, and documentation of nutritional therapies within the medication administration process have been identified recently in the literature. 25,49 For example, Citty, et al reported on a hospital systems' efforts to develop an electronic nutrition medication record (ENAR) within an existing EHR to improve ordering, administration, documentation, and evaluation of ONS within the medication record. The authors found that this improved the process and workflow of the system, as well as improved the documentation of nutritional medications.…”

Section: Optimizing Nutrition Monitoringmentioning

confidence: 99%

Optimizing Nutrition Care for Pressure Injuries in Hospitalized Patients

Citty

Cowan

Wingfield

et al. 2019

Advances in Wound Care

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It is estimated that up to 50% of hospitalized patients are malnourished. Malnutrition can lead to longer hospital stays, altered immune function, and impaired skin integrity and wound healing. Malnutrition has been found to be a significant factor influencing pressure injury (PI) risk and wound healing. While PI prevention requires multidimensional complex care using a variety of evidence-based strategies, hospitalized patients benefit from interventions that focus on improving oral nutrition to reduce PI risk and enhance wound healing. Unfortunately, malnutrition is often underrecognized and inadequately managed in hospitalized patients and this can lead to higher rates of complications such as PI. Recent Advances: Recent studies suggest that nutritional care has a major impact in PI prevention and management. Strategies, including early identification and management of malnutrition and provision of specially-formulated oral nutritional interventions to at-risk patients, optimization of electronic health record systems to allow for enhanced administration, monitoring, and evaluation of nutritional therapies, and implementation of protocol-based computerized decision support systems, have been reported to improve outcomes. Critical Issues: Unfortunately, there are gaps in the implementation of nutritional care in hospitals. Timely identification and management of malnutrition is needed to advance quality care for hospitalized patients and reduce malnutrition and associated PI. Future Directions: Further research on effective, evidence-based strategies for implementation of all stages of the nutrition care process is needed to reduce pressure injuries and malnutrition in hospitalized patients.

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“…during medication rounds, with a mean increased intake of of 35 ml (84 kcal) per day, (p < 0.001). 19 Another recent quality-improvement project that found that scheduled malnutrition screening by nurses and early, scheduled initiation of ONS for malnourished patients significantly reduced hospital length of stay and reduce delay in initiation of nutrition support therapy. 20,21…”

Section: Discussionmentioning

confidence: 99%

Enteral Nutrition Administration Record Prescribing Process Using Computerized Order Entry: A New Paradigm and Opportunities to Improve Outcomes in Critically Ill Patients

Kamel

Rosenthal

Citty

et al. 2020

J Parenter Enteral Nutr

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Background Prevalence of malnutrition has been reported in 60% of hospitalized and up to 78% of patients admitted to intensive care units. Malnutrition has been associated with complications, such as infection, increased hospital length of stay, morbidity, and mortality. Nutritional support has been shown to reduce avoidable readmissions, pressure ulcers, malpractice claims, and hospital costs. Creating a new electronic nutrition administration record (ENAR) with a linked nutrition tab within the electronic health record (EHR) would promote enhanced patient outcomes by improving adherence to established institutional enteral nutrition (EN) protocols and achieving early energy goals. Additionally, it would enable a clear and standardized method for documentation and administration of EN therapy. Methods The multidisciplinary nutrition support team was established and met on a weekly basis to discuss strategies and barriers, identify stakeholders, evaluate the current state, and establish a process and workflow from the point of order entry, delivery, administration, and electronic documentation of orders of EN supplements. The aim of this article is to describe a systematic approach and process of creating a new ENAR with a linked nutrition tab in the EHR, and to illustrate the order panel built and lessons learned from the process. Results A separate nutrition tab was created in the EHR with minimal disruption in patient care and end‐users’ positive feedback for the new order panel. Conclusion ENAR allows for easier data collection and promotes nutrition‐related research that may result in enhanced patient care. Utilizing technology to build a full ENAR would result in optimized patient care and safety.

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The effects of the administration of oral nutritional supplementation with medication rounds on the achievement of nutritional goals: A randomized controlled trial

Cited by 18 publications

References 19 publications

Adherences to oral nutritional supplementation among hospital outpatients: An online cross-sectional survey in Japan

Adherences to oral nutritional supplementation among hospital outpatients: An online cross-sectional survey in Japan

Optimizing Nutrition Care for Pressure Injuries in Hospitalized Patients

Enteral Nutrition Administration Record Prescribing Process Using Computerized Order Entry: A New Paradigm and Opportunities to Improve Outcomes in Critically Ill Patients

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