Quality indicators in nutrition therapy within the intensive care setting of a Brazilian teaching hospital

Authors

DOI:

https://doi.org/10.20435/inter.v20i3.1759

Keywords:

Nutrition Therapy, Quality Indicators, Health Care, Enteral Nutrition, Parenteral Nutrition, Quality Management.

Abstract

The quality of nutritional therapy was evaluated in an adult intensive care unit in a Brazilian teaching hospital, using ten indicators expressing target quality rates were selected from a list compiled by the Clinical Nutrition Task force of the Brazilian chapter of the International Life Sciences Institute (ILSI-Brasil). It was observed that the use of quality indicators of nutritional therapy allowed the identification of compliance and nonconformity processes, which still need additional adjustments. 

Author Biographies

Teresa Cristina Abranches Rosa, Universidade Federal de Mato Grosso do Sul

Graduation in Nutrition by the Federal University of Viçosa (UFV), specialization by the Multiprofessional Health Residency Program - Critical Patient Care - Federal University of Mato Grosso do Sul (UFMS) - Maria Aparecida Pedrossian University Hospital (HUMAP) and master's degree in metabolism and nutrition by the Post-Graduate Program in Health and Development in the Central-West Region (UFMS). She is currently a Nutritionist at UFMS, and tutor in the Multiprofessional Health Residency Program - Critical Patient Care at UFMS / HUMAP; tutor in the Multiprofessional Residency Program in Integrated Continuing Care - Concentration Area: Elderly Health Care/UFMS/Hospital São Julião and professor at Campo Grande College in Nutrition Course.

Mariana Raslan, Universidade Federal de Mato Grosso do Sul

Adjunct Professor, Faculty of Medicine, Federal University of Mato Grosso do Sul (UFMS). Specialist in Clinical Nutrition by GANEP (Human Nutrition). PhD from the Faculty of Medicine of the University of São Paulo. Performance in the area of clinical nutrition, malnutrition and nutritional screening of hospitalized patients.

Albert Schiaveto de Souza, Universidade Federal de Mato Grosso do Sul

Graduation in Physiotherapy from the State University of Londrina, a master's degree and a doctorate in Sciences (Physiology) from the University of São Paulo, Ribeirão Preto campus, and completed postdoctoral studies at the University of Oxford, UK, in 2013. He worked at the Hospital Adventista do Pênfigo from 1989 to 1998 (Campo Grande, MS), and as a professor at the Dom Bosco Catholic University (UCDB) from 1996 to 2008 (Campo Grande, MS). Since 2008, he has been a professor at the Federal University of Mato Grosso do Sul (UFMS), currently associate professor at the undergraduate level. He is an accredited counselor in the Post-Graduate Program in Health and Development in the Central-West Region; Post-Graduate Program in Dentistry at UFMS; Graduate Program in Family Health and collaborator in the Master's Program in Pharmacy at UFMS, and is the current director of the Biosciences Institute at UFMS. Evaluator of INEP / MEC for the Physiotherapy course. He has experience in the areas of Physical Therapy and Neurophysiology, acting mainly in the following subjects: neuronal plasticity, spatial memory, physiology of the genes of the base of the brain and biostatistics.

Karine de Cássia Freitas Gielow, Universidade Federal de Mato Grosso do Sul

Graduation in nutrition by Federal University of Ouro Preto, master's degree and doctorate in Sciences from the Federal University of São Paulo (UNIFESP). She has experience in the area of Clinical and Experimental Nutrition. Currently is an Professor in the Nutrition Course of the Federal University of Mato Grosso do Sul (UFMS) and permanent professor of the Post-Graduation Program in Health and Development in the Center-West Region (UFMS).

References

AGARWAL, Ekta; FERGUSON, Maree; BANKS, Merrilyn; BAUER, Judith; CAPRA, Sandra; ISENRING, Elisabeth. Nutritional status and dietary intake of acute care patients: results from the Nutrition Care Day Survey 2010. Clinical Nutrition, Edimburgo, v. 31, n. 1, p. 41-47, Sep 2012. https://doi.org/10.1016/j.clnu.2011.08.002

BRAUN, Jan-Peter; KUMPF, Oliver; DEJA, Maria; BRINKMANN, Alexander; MARX, Gernot; BLOOS, Frank; KALTWASSER, Arnold; DUBB, Rolf; MUHL, Elke; GREIM, Clemens; BAUSE, Hanswerner; WEILER, Norbert; CHOP, Ines; WAYDHAS, Christian; SPIES, Claudia. The German quality indicators in intensive care medicine 2013–second edition. GMS German Medical Science, Berlim, v. 11, p.1-17, Jul 2013. ISSN 1612-3174. doi: 10.3205/000177

BTAICHE, Imad F.; CHAN, Lingtak-Neander; PLEVA, Melissa; KRAFT, Michael D. Critical illness, gastrointestinal complications, and medication therapy during enteral feeding in critically ill adult patients. Nutrition in Clinical Practice, Bethesda, v. 25, n. 1, p. 32-49, Feb 2010. https://doi.org/10.1177%2F0884533609357565

CARTOLANO, Flávia De Conti; CARUSO, Lúcia; SORIANO, Francisco Garcia. Enteral nutritional therapy: application of quality indicators. Revista Brasileira de Terapia Intensiva, São Paulo, v. 21, n. 4, p. 376-383, Oct 2009. http://dx.doi.org/10.1590/S0103-507X2009000400007

CENICCOLA, Guilherme Duprat; ARAÚJO, Wilma Maria Coelho; AKUTSU, Rita. Development of a tool for quality control audits in hospital enteral nutrition. Nutrición Hospitalaria, Madrid, v. 29, n. 1, p. 102-120, Oct 2014. DOI:10.3305/nh.2014.29.1.7071

GUENTER, Peggi. Safe practices for enteral nutrition in critically ill patients. Critical care nursing clinics of North America, Maryland Heights, v. 22, n. 2, p. 197-208, Jun 2010. https://doi.org/10.1016/j.ccell.2010.03.009

HEYLAND, Daren K.; CAHILL, Naomi E.; DHALIWAL, Rupinder; SUN, Xiaoqun; DAY, Andrew G.; MCCLAVE, Stephen A. Impact of enteral feeding protocols on enteral nutrition delivery: results of a multicenter observational study. Journal of Parenteral and Enteral Nutrition, Silver Spring, v. 34, n. 6, p. 675-684, Nov/Dec 2010.

KREYMANN, Georg. New developments in clinical practice guidelines. South African Journal of Clinical Nutrition, Lyttelton, v. 23, n. sup1, p. 29-32, 2010. http://dx.doi.org/10.1080/16070658.2010.11734266

LEE, Ariana; FILHO, Ronaldo Sousa Oliveira; CARDENAS, Thais de Campo; OZÓRIO, Gislaine Aparecida; GROPP, Juliana Pereira Lima; WAITZBERG, Dan Linetzky. Quality control of enteral nutrition therapy in cancer patients at nutritional risk. Nutrición Hospitalaria, Madrid, v. 34, n. 2, p. 264-270, Mar 2017.

LEISTRA, Eva; VAN BOKHORST-DE VAN DER SCHUEREN, Marian AE; VISSER, Marjolein; VAN DER HOUT, Anja; LANGIUS, Jacqueline AE; KRUIZENGA, Hinke M. Systematic screening for undernutrition in hospitals: predictive factors for success. Clinical Nutrition, Edimburgo, v. 33, n. 3, p. 495-501, Jun 2014. https://doi.org/10.1016/j.clnu.2013.07.005

MARTINDALE, Robert G.; MCCLAVE, Stephen A.; VANEK, Vincent W.; MCCARTHY, Mary; ROBERTS, Pamela; TAYLOR, Beth; OCHOA, Juan B.; NAPOLITANO, Lena; CRESCI, Gail. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition: Executive Summary. Critical Care Medicine, Mount Prospect, v. 37, n. 5, p. 1757-1761, May 2009. DOI: 10.1097/CCM.0b013e3181a40116

MCCLAVE, Stephen A.; TAYLOR, Beth E.; MARTINDALE, Robert G.; WARREN, Malissa M.; JOHNSON, Debbie R.; BRAUNSCHWEIG, Carol; MCCARTHY, Mary S.; DAVANOS, Evangelia; RICE, Todd W.; CRESCI, Gail A.; GERVASIO, Jane M.; SACKS, Gordon S.; ROBERTS, Pamela R.; COMPHER, Charlene. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). Journal of Parenteral and Enteral Nutrition, Silver Spring, v. 40, n. 2, p. 159–211, 2016. DOI: 10.1177/0148607115621863

MUELLER, Charles; COMPHER, Charlene; ELLEN, Druyan Mary; American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of Directors. ASPEN clinical guidelines: nutrition screening, assessment, and intervention in adults. Journal of Parenteral and Enteral Nutrition, Thousand Oaks, v. 35, n. 1, p. 16-24, Jan 2011. https://doi.org/10.1177%2F0148607110389335

NICE-SUGAR STUDY INVESTIGATORS. Intensive versus conventional glucose control in critically ill patients. The New England Journal of Medicine, Waltham, v. 360, n. 13, p. 1283-1297, Mar 2009. DOI: 10.1056/NEJMoa0810625

POLAGE, Christopher R.; SOLNICK, Jay V.; COHEN, Stuart H. Nosocomial diarrhea: evaluation and treatment of causes other than Clostridium difficile. Clinical Infectious Diseases, Oxford, v. 55, n. 7, p. 982-989, Oct 2012. https://doi.org/10.1093/cid/cis551

POULIA, Kalliopi-Anna; YANNAKOULIA, Mary; KARAGEORGOU, Dimitra; GAMALETSOU, Maria; PANAGIOTAKOS, Demosthenes B.; SIPSAS, Nikolaos V.; ZAMPELAS, Antonis. Evaluation of the efficacy of six nutritional screening tools to predict malnutrition in the elderly. Clinical Nutrition, Edimburgo, v. 31, n. 3, p. 378-385, Jun 2012. https://doi.org/10.1016/j.clnu.2011.11.017

RASLAN, Mariana; GONZALEZ, Maria Cristina; DIAS, Maria Carolina Gonçalves; NASCIMENTO, Mariana; CASTRO, Melina; MARQUES, Patrícia; SEGATTO, Sabrina; TORRINHAS, Raquel Susana; CECCONELLO, Ivan; WAITZBERG, Dan Linetzkyet. Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients. Nutrition, Burbank, v. 26, n. 7, p. 721-726, Jul 2010. https://doi.org/10.1016/j.nut.2009.07.010

RASLAN, Mariana; GONZALEZ, Maria Cristina; TORRINHAS, Raquel Suzana M.M.; RAVACCI, Graziela Rosa; PEREIRA, Julio C.R.; WAITZBERG, Dan L. Complementarity of Subjective Global Assessment (SGA) and Nutritional Risk Screening 2002 (NRS 2002) for predicting poor clinical outcomes in hospitalized patients. Clinical Nutrition, Edimburgo, v. 30, n. 1, p. 49-53, 2011. https://doi.org/10.1016/j.clnu.2010.07.002

RIBAS, Bruna Luiza P.; GARCIA, Rosane Scussel; ABIB, Renata Torres. Motivos para interrupção da terapia nutricional enteral em pacientes hospitalizados. Revista Brasileira de Nutrição Clínica, São Paulo, v. 29, n. 4, p. 331-4, Set 2014.

SCHÖNHERR, Silvia; HALFENS, Ruud J.G.; MEIJERS, Judith M.M.; SCHOLS, Jos M.G.A.; LOHRMANN, Christa. Structural and process indicators of nutritional care: a comparison between Austrian hospitals and nursing homes. Nutrition, Burbank, v. 28, n. 9, p. 868-873, Sep 2012. https://doi.org/10.1016/j.nut.2011.11.007

SHIROMA, Glaucia Midori; HORIE, Lilian Mika; CASTRO, Melina Gouveia; MARTINS, Juliana R.; BITTENCOURT, Amanda F.; LOGULLO, Luciana; SILVA, Maria de Lourdes Teixeira da; WAITZBERG, Dan L. Nutrition Quality Control in the Prescription and Administration of Parenteral Nutrition Therapy for Hospitalized Patients. Nutrition in Clinical Practice. Bethesda, v.30, n.3, p. 406 – 413, Jun 2015. https://doi.org/10.1177%2F0884533614567540

SINGER, Pierre; BERGER, Mette M.; VAN DEN BERGHE, Greet; BIOLO, Gianni; CALDER, Philip; FORBES, Alastair; GRIFFITHS, Richard; KREYMAN, Georg; LEVERVE, Xavier; PICHARD, Claude. ESPEN guidelines on parenteral nutrition: intensive care. Clinical Nutrition, Edimburgo, v. 28, n. 4, p. 387-400, Feb 2009. https://doi.org/10.1016/j.clnu.2009.04.024

THIBAULT, Ronan; GRAF, Séverine; CLERC, Aurélie; DELIEUVIN, Nathalie; HEIDEGGER, Claudia Paula; PICHARD, Claude. Diarrhoea in the ICU: respective contribution of feeding and antibiotics. Critical Care, London, v. 17, n. 4, p. R153, Jul 2013. https://doi.org/10.1186/cc12832

VALENTIN, Andreas; FERDINANDE, Patrick; ESICM Working Group on Quality Improvement. Recommendations on basic requirements for intensive care units: structural and organizational aspects. Intensive care medicine. Ottawa, v.37, n.10. p.1575–1587, Sep 2011. doi: 10.1007/s00134-011-2300-7

VEROTTI, Cristiane Comeron Gimenez; TORRINHAS, Raquel Susana Matos de Miranda; CECCONELLO, Ivan; WAITZBERG, Dan Linetzky. Selection of top 10 quality indicators for nutrition therapy. Nutrition in Clinical Practice, Bethesda, v. 27, n. 2, p. 261-267, Jan 2012. https://doi.org/10.1177%2F0884533611432317

WAITZBERG, Dan L. Indicadores de qualidade em terapia nutricional. 1.ed. São Paulo: ILSI Brasil, 2008.

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Published

2019-09-23

How to Cite

Rosa, T. C. A., Raslan, M., Souza, A. S. de, & Gielow, K. de C. F. (2019). Quality indicators in nutrition therapy within the intensive care setting of a Brazilian teaching hospital. Interações (Campo Grande), 20(3), 923–932. https://doi.org/10.20435/inter.v20i3.1759

Issue

Interações v. 20, n. 3, jul./set. 2019

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