QUALITY INDICATOR IN THE NUTRITIONAL CARE OF CRITICALLY ILL PATIENTS IN A PRIVATE HOSPITAL - BRAZIL

Background and objectives: Patients on nutritional therapy should be monitored routinely, and this evaluation should ensure that the best therapy is being offered for clinical recovery. Our objective was to create a tool to measure and monitor the quality of therapy provided to the critical patient aiming at nutritional recovery. Methods: All hospitalized patients underwent a nutritional evaluation and were classified into 2 groups: with or without nutritional risk. Patients with nutritional risk were reevaluated every 7 to 10 days, taking into account: tolerance of the oral, enteral or parenteral therapy, biochemical tests and anthropometric measures. Based on the results, the patient was classified into three categories: worsening, maintenance or improvement of nutritional status. The monthly goal was to achieve at least 75% maintenance or improvement of nutritional status in these patients. Results: The proposed target was reached between January and June 2016 (mean 92.1%), so in July a new target of 92% was proposed. Between July 2016 and April 2017, only 2 monthly measurements showed results below the expected target: October 2016 (91.5%) and January 2017 (89.3%). Analyzing the data, specific actions were implemented to reverse the critical points of nutritional care like early oral supplementation or enteral therapy. Conclusions: Nutritional therapy is essential for the critical patient and the implementation of tools to measure the quality of care contributes to an effective and individualized nutritional therapy aiming at the clinical recovery of patients, at a lower cost.