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      Abordaje de la nutrición parenteral mediante la creación de un grupo multidisciplinar Translated title: Approach to parenteral nutrition through the creation of a multidisciplinary group

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          Abstract

          Resumen Objetivo: La desnutrición hospitalaria incrementa el riesgo de padecer complicaciones, agravado por la escasa formación y sensibilidad en nutrición clínica del personal sanitario. El objetivo del presente estudio es evaluar la capacidad de optimización de la prescripción de nutrición parenteral como consecuencia de la creación de un grupo multidisciplinar. Métodos: Se creó un equipo multidisciplinar para asesorar a los servicios médico-quirúrgicos en nutrición, optimizar la prescripción de nutrición parenteral e informar y empoderar al paciente. Se establecieron las bases para el funcionamiento de un grupo asesor de nutrición parenteral (GANP) que se reunió de forma diaria para evaluar las prescripciones de nutrición parenteral del centro, realizando una entrevista clínica y una valoración nutricional individualizada y decidió sobre el tratamiento nutricional más adecuado en cada paciente. Se establecieron diferentes grados de desempeño (pobre 0-20%, adecuado 21-50%, bueno 51-80% o excelente >80%) en función del porcentaje de NP centrales asumidas y el grado de satisfacción del paciente. Se proporcionaron encuestas de satisfacción voluntarias a los pacientes, y se valoraron en una escala de 0 a 10. Resultados: Se evaluaron 97 pacientes con NP durante un año. El 100% de las NP centrales fueron asumidas por el GANP (68,3% de las NP totales). El 92,7% de las nutriciones totales estuvieron indicadas correctamente y en el 74,8% la prescripción fue adecuada. El grado de satisfacción medio fue de 9,5/10,0. El programa obtuvo un grado de desempeño excelente. Conclusiones: La creación de un grupo de trabajo multidisciplinar contribuye a la optimización de la terapia nutricional.

          Translated abstract

          Summary Objective: Hospital malnutrition increases the risk of complications, aggravated by the scarce training and sensitivity in clinical nutrition of health personnel. The objective is to evaluate the optimization capacity of parenteral nutrition prescription as a consequence of the creation of a multidisciplinary group. Methods: A multidisciplinary team was created to advise the medical-surgical services on nutrition, optimize the prescription of parenteral nutrition and inform and empower the patient. The foundations were established for the functioning of a parenteral nutrition advisory group (GANP) that met daily to evaluate the center's parenteral nutrition prescriptions, conducting a clinical interview and an individualized nutritional assessment and decided on the most appropriate nutritional treatment in each patient. Different degrees of performance were established (poor 0-20%, adequate 21-50%, good 51-80% or excellent >80%) depending on the percentage of assumed central PNs and the degree of patient satisfaction. Voluntary satisfaction surveys were provided to patients, and they were rated on a scale of 0 to 10. Results: 97 patients with PN were evaluated for one year. 100% of the central NPs were assumed by the GANP (68.3% of the total NPs). 92.7% of the total nutritionals were indicated correctly and in 74.8% the prescription was adequate. The average degree of satisfaction was 9.5/10.0. The program obtained an excellent performance grade. Conclusions: The creation of a multidisciplinary working group contributes to the optimization of nutritional therapy.

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          Most cited references19

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          Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients.

          (2002)
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            Efficacy and Efficiency of Nutritional Support Teams

            Malnutrition is frequent in patients during a hospital admission and may further worsen during the hospital stay without appropriate nutritional support. Malnutrition causes greater complication rates, morbidity, and mortality rates, which increases the length of hospital stay and prolongs rehabilitation. Early recognition of individual nutritional risk and timely initiation of a tailored nutritional therapy are crucial. Recent evidence from large-scale trials suggests that efficient nutritional management not only improves the nutritional status, but also prevents negative clinical outcomes and increases patients’ quality of life. Multifaceted clinical knowledge is required to ensure optimal nutritional support, according to a patient’s individual situation and to avoid potential complications. Furthermore, clear definition of responsibilities and structuring of patient, and work processes are indispensable. Interdisciplinary and multiprofessional nutritional support teams have been built up to ensure and improve the quality and safety of nutritional treatments. These teams continuously check and optimize the quality of procedures in the core areas of nutritional management by implementing nutritional screening processes using a validated tool, nutritional status assessment, an adequate nutritional care plan development, prompt and targeted nutritional treatment delivery, and provision of accurate monitoring to oversee all aspects of care, from catering to artificial nutrition. The foundation of any nutritional care plan is the identification of patients at risk. The aim of this narrative review is to provide an overview about composition, tasks, and challenges of nutritional support teams, and to discuss the current evidence regarding their efficiency and efficacy in terms of clinical outcome and cost effectiveness.
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              Standards for Nutrition Support: Adult Hospitalized Patients.

              The American Society for Parenteral and Enteral Nutrition defines standards as benchmarks representing a range of performance of competent care that should be provided to assure safe and efficacious nutrition care in most circumstances. Standards are documents that define the structure needed to provide competent care. These Standards for Nutrition Support for Adult Hospitalized Patients are an update of the 2010 Standards. These practice-based standards are intended for use by healthcare professionals charged with the care of adult hospitalized patients receiving nutrition support therapy in any hospital with or without a formal nutrition support service or team. These Standards address professional responsibilities as they relate to patient assessment, diagnosis, education, care plan development, implementation, clinical monitoring, evaluation, and professional issues around nutrition support.
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                Author and article information

                Journal
                ofil
                Revista de la OFIL
                Rev. OFIL·ILAPHAR
                Organización de Farmacéuticos Ibero-Latinoamericanos (Madrid, Madrid, Spain )
                1131-9429
                1699-714X
                March 2022
                : 32
                : 1
                : 63-68
                Affiliations
                [2] Alicante orgnameHospital Universitario Sant Joan d'Alacant orgdiv1Sección de Endocrinología y Nutrición España
                [1] Alicante orgnameHospital Universitario Sant Joan d'Alacant orgdiv1Servicio de Farmacia España
                Article
                S1699-714X2022000100011 S1699-714X(22)03200100011
                10.4321/s1699-714x20220001000011
                a9033a3c-d514-4c01-a3f9-ed6d26453bfd

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 24 November 2020
                : 22 October 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 6
                Product

                SciELO Spain

                Categories
                Originales

                estándar de atención,Parenteral nutrition,parenteral nutrition total,medication error,nutrition assessment,nutrition support,standard of care,Nutrición parenteral,nutrición parenteral total,error de medicación,evaluación nutricional,apoyo nutricional

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