Elevada frequência de não conformidade de indicadores de qualidade em terapia nutricional enteral e parenteral em pacientes hospitalizados

Abstract

Background: Quality indicators in nutritional therapy (QINT) are measures of the effectiveness and quality of nutritional assistance. The purpose of this study was to evaluate the frequency of QINT adequacy of Enteral Nutritional Therapy (ENT) and/or Parenteral (PNT) in clinical and surgical patients, and identifying the best indicators according to the opinions of professionals. Methods: Prospective study, including data from all patients admitted to clinical or surgical wards was performed. Patients who had received ENT and/or PNT were followed from the first day of nutritional prescription until discharge. Twelve indicators were calculated, as recommended by the International Life Sciences Institute. Regarding professional opinion, QINT adequacy was evaluated by observing four attributes (utility, simplicity, objectivity and low cost). Results: Of the 727 patients hospitalized in clinical and surgical wards, 101 were on ENT and/or PNT. Regarding the 12 QINT evaluated, only 25%(3) achieved the goals: involuntary withdrawal of enteral feeding tube (0.01%); feeding tube occlusion or withdrawal per occlusion (0%); measurement of energy and protein requirements (92%). However, 75%(9) of QINT did not achieve goals such as frequency of: carrying out nutrition screening within 24 hours (9.1%); application of Subjective Global Assessment (55.5%), among others. Conclusion: A high frequency of non-compliance (75% of QINT) was observed in clinical and surgical patients on ENT and/or PNT. With knowledge of the six best indicators chosen by health professionals in this service, it will be possible to elaborate protocols according to the real-life situation in the institution.