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Parenteral nutrition support: Beyond gut feeling? Quality control study of parenteral nutrition practices in a Tertiary Care Hospital.

Ramakrishnan N, Shankar B, Ranganathan L, Daphnee DK, Bharadwaj A, Venkataraman R - Indian J Crit Care Med (2016)

Bottom Line: The proportion of patients receiving PN was very low.Quality issues were identified relating to appropriateness of indication and calories and proteins delivered.This study helps to introspect and improve the quality of nutrition support.

View Article: PubMed Central - PubMed

Affiliation: Department of Critical Care, Apollo Hospitals, Chennai, Tamil Nadu, India.

ABSTRACT

Background: Enteral nutrition (EN) is preferred over parenteral nutrition (PN) in hospitalized patients based on International consensus guidelines. Practice patterns of PN in developing countries have not been documented.

Objectives: To assess practice pattern and quality of PN support in a tertiary hospital setting in Chennai, India.

Methods: Retrospective record review of patients admitted between February 2010 and February 2012.

Results: About 351,008 patients were admitted to the hospital in the study period of whom 29,484 (8.4%) required nutritional support. About 70 patients (0.24%) received PN, of whom 54 (0.18%) received PN for at least three days. Common indications for PN were major gastrointestinal surgery (55.6%), intolerance to EN (25.9%), pancreatitis (5.6%), and gastrointestinal obstruction (3.7%).

Conclusions: The proportion of patients receiving PN was very low. Quality issues were identified relating to appropriateness of indication and calories and proteins delivered. This study helps to introspect and improve the quality of nutrition support.

No MeSH data available.


Related in: MedlinePlus

Framework for quality assessment of parenteral nutrition
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Figure 1: Framework for quality assessment of parenteral nutrition

Mentions: This study was done through a retrospective record review of all hospitalizations between February 2010 and February 2012. A checklist of items relevant to nutritional support was used to mine the data. PN support was defined as PN provided for at least 3 consecutive days of hospitalization. Data were validated by random supervisory checks and exported to a spreadsheet. All patient identifiers were masked and only relevant clinical information was extracted. The four components of the quality assessment framework followed in this study were proportion of nutrition provided as PN, appropriateness of indication, process, and effectiveness of PN delivery [Figure 1]. Simple descriptive analysis was done to understand the pattern and profile of patients. Effectiveness of delivery of calorie and protein were analyzed using Student's t-test, and P < 0.05 was considered significant. Statistical analyses were performed using SPSS statistical software (SPSS Statistics 17.0, Chicago, IL, USA). Since it was part of routine quality control process of the hospital, Ethical Committee approval was not sought.


Parenteral nutrition support: Beyond gut feeling? Quality control study of parenteral nutrition practices in a Tertiary Care Hospital.

Ramakrishnan N, Shankar B, Ranganathan L, Daphnee DK, Bharadwaj A, Venkataraman R - Indian J Crit Care Med (2016)

Framework for quality assessment of parenteral nutrition
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4759992&req=5

Figure 1: Framework for quality assessment of parenteral nutrition
Mentions: This study was done through a retrospective record review of all hospitalizations between February 2010 and February 2012. A checklist of items relevant to nutritional support was used to mine the data. PN support was defined as PN provided for at least 3 consecutive days of hospitalization. Data were validated by random supervisory checks and exported to a spreadsheet. All patient identifiers were masked and only relevant clinical information was extracted. The four components of the quality assessment framework followed in this study were proportion of nutrition provided as PN, appropriateness of indication, process, and effectiveness of PN delivery [Figure 1]. Simple descriptive analysis was done to understand the pattern and profile of patients. Effectiveness of delivery of calorie and protein were analyzed using Student's t-test, and P < 0.05 was considered significant. Statistical analyses were performed using SPSS statistical software (SPSS Statistics 17.0, Chicago, IL, USA). Since it was part of routine quality control process of the hospital, Ethical Committee approval was not sought.

Bottom Line: The proportion of patients receiving PN was very low.Quality issues were identified relating to appropriateness of indication and calories and proteins delivered.This study helps to introspect and improve the quality of nutrition support.

View Article: PubMed Central - PubMed

Affiliation: Department of Critical Care, Apollo Hospitals, Chennai, Tamil Nadu, India.

ABSTRACT

Background: Enteral nutrition (EN) is preferred over parenteral nutrition (PN) in hospitalized patients based on International consensus guidelines. Practice patterns of PN in developing countries have not been documented.

Objectives: To assess practice pattern and quality of PN support in a tertiary hospital setting in Chennai, India.

Methods: Retrospective record review of patients admitted between February 2010 and February 2012.

Results: About 351,008 patients were admitted to the hospital in the study period of whom 29,484 (8.4%) required nutritional support. About 70 patients (0.24%) received PN, of whom 54 (0.18%) received PN for at least three days. Common indications for PN were major gastrointestinal surgery (55.6%), intolerance to EN (25.9%), pancreatitis (5.6%), and gastrointestinal obstruction (3.7%).

Conclusions: The proportion of patients receiving PN was very low. Quality issues were identified relating to appropriateness of indication and calories and proteins delivered. This study helps to introspect and improve the quality of nutrition support.

No MeSH data available.


Related in: MedlinePlus