Education program on medical nutrition and length of stay of critically ill patients
Summary Background & aims To evaluate the impact of a multifaceted nutritional educational intervention on the quality of nutritional therapy and clinical outcomes in critically ill patients. Methods We conducted a prospective, non-blinded study with a non-contemporaneous control group at a 16-b...
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| Veröffentlicht in: | Clinical nutrition (Edinburgh, Scotland) Scotland), 2013-12, Vol.32 (6), p.1061-1066 |
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| creator | Castro, Melina Gouveia Pompilio, Carlos Eduardo Horie, Lilian Mika Verotti, Cristiane Comeron Gimenez Waitzberg, Dan Linetzky |
| description | Summary Background & aims To evaluate the impact of a multifaceted nutritional educational intervention on the quality of nutritional therapy and clinical outcomes in critically ill patients. Methods We conducted a prospective, non-blinded study with a non-contemporaneous control group at a 16-bed intensive care unit (ICU) at the Hospital das Clinicas, Department of Gastroenterology, University of Sao Paulo Medical School in Sao Paulo, Brazil. There were three phases. Phase 1: the quality of NT was evaluated in 50 newly admitted intensive care unit patients in a pre-educational program (Pre-EP). Phase 2: nutritional protocols were created and an education program was implemented. Phase 3: another 50 patients were enrolled and observed in a post-educational program (Post-EP) using phase 1 methodology. Nutritional Therapy practice was evaluated through nutritional assessments, adequacy of energy requirements, duration of fasting, and use of early enteral nutrition. Intensive care unit length of stay and hospital length of stay were measured as primary end-points. Results The pre-educational program and post-educational program groups did not differ in age, APACHE II score, gender, or nutritional assessment. The mean ± SD duration of fasting decreased (Pre-EP 3.8 ± 3.1 days vs. Post-EP: 2.2 ± 2.6 days; p = 0.002), the adequacy of nutritional therapy improved (Pre-EP 74.2% ± 33.3% vs. Post-EP 96.2% ± 23.8%; p |
| doi_str_mv | 10.1016/j.clnu.2012.11.023 |
| format | Article |
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Methods We conducted a prospective, non-blinded study with a non-contemporaneous control group at a 16-bed intensive care unit (ICU) at the Hospital das Clinicas, Department of Gastroenterology, University of Sao Paulo Medical School in Sao Paulo, Brazil. There were three phases. Phase 1: the quality of NT was evaluated in 50 newly admitted intensive care unit patients in a pre-educational program (Pre-EP). Phase 2: nutritional protocols were created and an education program was implemented. Phase 3: another 50 patients were enrolled and observed in a post-educational program (Post-EP) using phase 1 methodology. Nutritional Therapy practice was evaluated through nutritional assessments, adequacy of energy requirements, duration of fasting, and use of early enteral nutrition. Intensive care unit length of stay and hospital length of stay were measured as primary end-points. Results The pre-educational program and post-educational program groups did not differ in age, APACHE II score, gender, or nutritional assessment. The mean ± SD duration of fasting decreased (Pre-EP 3.8 ± 3.1 days vs. Post-EP: 2.2 ± 2.6 days; p = 0.002), the adequacy of nutritional therapy improved (Pre-EP 74.2% ± 33.3% vs. Post-EP 96.2% ± 23.8%; p < 0.001), and enteral nutrition was initiated earlier than 48 h more commonly (Pre-EP 24% vs. Post-E 60%; p = 0.001). Median intensive care unit length of stay decreased (Pre-EP: 18.5 days vs. Post-EP: 9.5 days; p < 0.001) although hospital length of stay did not. Conclusion Implementing a multifaceted nutritional educational intervention could improve the quality of nutritional therapy and may decrease intensive care unit length of stay in critically ill patients.</description><identifier>ISSN: 0261-5614</identifier><identifier>EISSN: 1532-1983</identifier><identifier>DOI: 10.1016/j.clnu.2012.11.023</identifier><identifier>PMID: 23260748</identifier><identifier>CODEN: CLNUDP</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Aged ; Biological and medical sciences ; Critical care ; Critical Illness - therapy ; education programs ; Education, Medical, Continuing ; Educational program ; energy requirements ; enteral feeding ; fasting ; Feeding. Feeding behavior ; Female ; Fundamental and applied biological sciences. Psychology ; Gastroenterology and Hepatology ; gender ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Middle Aged ; Nutrition Assessment ; Nutrition Therapy - methods ; nutritional adequacy ; Nutritional Requirements ; Nutritional Sciences - education ; Nutritional therapy ; nutritive value ; patients ; Prospective Studies ; Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><ispartof>Clinical nutrition (Edinburgh, Scotland), 2013-12, Vol.32 (6), p.1061-1066</ispartof><rights>Elsevier Ltd and European Society for Clinical Nutrition and Metabolism</rights><rights>2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-266754429576129cf5dd08cd0aa4de21820ee927efcc4945c5feb885b0f00de63</citedby><cites>FETCH-LOGICAL-c465t-266754429576129cf5dd08cd0aa4de21820ee927efcc4945c5feb885b0f00de63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clnu.2012.11.023$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27947987$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23260748$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Castro, Melina Gouveia</creatorcontrib><creatorcontrib>Pompilio, Carlos Eduardo</creatorcontrib><creatorcontrib>Horie, Lilian Mika</creatorcontrib><creatorcontrib>Verotti, Cristiane Comeron Gimenez</creatorcontrib><creatorcontrib>Waitzberg, Dan Linetzky</creatorcontrib><title>Education program on medical nutrition and length of stay of critically ill patients</title><title>Clinical nutrition (Edinburgh, Scotland)</title><addtitle>Clin Nutr</addtitle><description>Summary Background & aims To evaluate the impact of a multifaceted nutritional educational intervention on the quality of nutritional therapy and clinical outcomes in critically ill patients. Methods We conducted a prospective, non-blinded study with a non-contemporaneous control group at a 16-bed intensive care unit (ICU) at the Hospital das Clinicas, Department of Gastroenterology, University of Sao Paulo Medical School in Sao Paulo, Brazil. There were three phases. Phase 1: the quality of NT was evaluated in 50 newly admitted intensive care unit patients in a pre-educational program (Pre-EP). Phase 2: nutritional protocols were created and an education program was implemented. Phase 3: another 50 patients were enrolled and observed in a post-educational program (Post-EP) using phase 1 methodology. Nutritional Therapy practice was evaluated through nutritional assessments, adequacy of energy requirements, duration of fasting, and use of early enteral nutrition. Intensive care unit length of stay and hospital length of stay were measured as primary end-points. Results The pre-educational program and post-educational program groups did not differ in age, APACHE II score, gender, or nutritional assessment. The mean ± SD duration of fasting decreased (Pre-EP 3.8 ± 3.1 days vs. Post-EP: 2.2 ± 2.6 days; p = 0.002), the adequacy of nutritional therapy improved (Pre-EP 74.2% ± 33.3% vs. Post-EP 96.2% ± 23.8%; p < 0.001), and enteral nutrition was initiated earlier than 48 h more commonly (Pre-EP 24% vs. Post-E 60%; p = 0.001). Median intensive care unit length of stay decreased (Pre-EP: 18.5 days vs. Post-EP: 9.5 days; p < 0.001) although hospital length of stay did not. Conclusion Implementing a multifaceted nutritional educational intervention could improve the quality of nutritional therapy and may decrease intensive care unit length of stay in critically ill patients.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Critical care</subject><subject>Critical Illness - therapy</subject><subject>education programs</subject><subject>Education, Medical, Continuing</subject><subject>Educational program</subject><subject>energy requirements</subject><subject>enteral feeding</subject><subject>fasting</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Gastroenterology and Hepatology</subject><subject>gender</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nutrition Assessment</subject><subject>Nutrition Therapy - methods</subject><subject>nutritional adequacy</subject><subject>Nutritional Requirements</subject><subject>Nutritional Sciences - education</subject><subject>Nutritional therapy</subject><subject>nutritive value</subject><subject>patients</subject><subject>Prospective Studies</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><issn>0261-5614</issn><issn>1532-1983</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9klGL1DAQgIMo3rr6B3zQvgi-tGbSpGlBBDnuVDjw4e6eQzadrlmz6Zq0B_vvnbqrgg8-JTDfTCbfDGMvgVfAoXm3q1yIcyU4iAqg4qJ-xFagalFC19aP2YqLBkrVgLxgz3Lecc5Vrdun7ELUouFatit2d9XPzk5-jMUhjdtk9wVd99h7Z0MR5yn5X0Eb-yJg3E7finEo8mSPy-mWKIHhWPgQigMVwjjl5-zJYEPGF-dzze6vr-4uP5c3Xz99ufx4UzrZqKkUTaOVlKJTugHRuUH1PW9dz62VPQpoBUfshMbBOdlJ5dSAm7ZVGz5w3mNTr9nbU11q_ceMeTJ7nx2GYCOOczYgVdfRN8nMmokT6tKYc8LBHJLf23Q0wM1i0-zMYtMsNg2AoRxKenWuP29IyZ-U3_oIeHMGbCYNQ7LR-fyX053UXauJe33iBjsau03E3N_SS4pGQgwsxPsTgeTrwWMy2ZFLR4NI6CbTj_7_nX74J90FH5fRfMcj5t04p0iTMGCyMNzcLpuxLAYIzoWGuv4JXiuw3w</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Castro, Melina Gouveia</creator><creator>Pompilio, Carlos Eduardo</creator><creator>Horie, Lilian Mika</creator><creator>Verotti, Cristiane Comeron Gimenez</creator><creator>Waitzberg, Dan Linetzky</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>FBQ</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>Education program on medical nutrition and length of stay of critically ill patients</title><author>Castro, Melina Gouveia ; Pompilio, Carlos Eduardo ; Horie, Lilian Mika ; Verotti, Cristiane Comeron Gimenez ; Waitzberg, Dan Linetzky</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-266754429576129cf5dd08cd0aa4de21820ee927efcc4945c5feb885b0f00de63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Critical care</topic><topic>Critical Illness - therapy</topic><topic>education programs</topic><topic>Education, Medical, Continuing</topic><topic>Educational program</topic><topic>energy requirements</topic><topic>enteral feeding</topic><topic>fasting</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Gastroenterology and Hepatology</topic><topic>gender</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nutrition Assessment</topic><topic>Nutrition Therapy - methods</topic><topic>nutritional adequacy</topic><topic>Nutritional Requirements</topic><topic>Nutritional Sciences - education</topic><topic>Nutritional therapy</topic><topic>nutritive value</topic><topic>patients</topic><topic>Prospective Studies</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Castro, Melina Gouveia</creatorcontrib><creatorcontrib>Pompilio, Carlos Eduardo</creatorcontrib><creatorcontrib>Horie, Lilian Mika</creatorcontrib><creatorcontrib>Verotti, Cristiane Comeron Gimenez</creatorcontrib><creatorcontrib>Waitzberg, Dan Linetzky</creatorcontrib><collection>AGRIS</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Castro, Melina Gouveia</au><au>Pompilio, Carlos Eduardo</au><au>Horie, Lilian Mika</au><au>Verotti, Cristiane Comeron Gimenez</au><au>Waitzberg, Dan Linetzky</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Education program on medical nutrition and length of stay of critically ill patients</atitle><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle><addtitle>Clin Nutr</addtitle><date>2013-12-01</date><risdate>2013</risdate><volume>32</volume><issue>6</issue><spage>1061</spage><epage>1066</epage><pages>1061-1066</pages><issn>0261-5614</issn><eissn>1532-1983</eissn><coden>CLNUDP</coden><abstract>Summary Background & aims To evaluate the impact of a multifaceted nutritional educational intervention on the quality of nutritional therapy and clinical outcomes in critically ill patients. Methods We conducted a prospective, non-blinded study with a non-contemporaneous control group at a 16-bed intensive care unit (ICU) at the Hospital das Clinicas, Department of Gastroenterology, University of Sao Paulo Medical School in Sao Paulo, Brazil. There were three phases. Phase 1: the quality of NT was evaluated in 50 newly admitted intensive care unit patients in a pre-educational program (Pre-EP). Phase 2: nutritional protocols were created and an education program was implemented. Phase 3: another 50 patients were enrolled and observed in a post-educational program (Post-EP) using phase 1 methodology. Nutritional Therapy practice was evaluated through nutritional assessments, adequacy of energy requirements, duration of fasting, and use of early enteral nutrition. Intensive care unit length of stay and hospital length of stay were measured as primary end-points. Results The pre-educational program and post-educational program groups did not differ in age, APACHE II score, gender, or nutritional assessment. The mean ± SD duration of fasting decreased (Pre-EP 3.8 ± 3.1 days vs. Post-EP: 2.2 ± 2.6 days; p = 0.002), the adequacy of nutritional therapy improved (Pre-EP 74.2% ± 33.3% vs. Post-EP 96.2% ± 23.8%; p < 0.001), and enteral nutrition was initiated earlier than 48 h more commonly (Pre-EP 24% vs. Post-E 60%; p = 0.001). Median intensive care unit length of stay decreased (Pre-EP: 18.5 days vs. Post-EP: 9.5 days; p < 0.001) although hospital length of stay did not. Conclusion Implementing a multifaceted nutritional educational intervention could improve the quality of nutritional therapy and may decrease intensive care unit length of stay in critically ill patients.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>23260748</pmid><doi>10.1016/j.clnu.2012.11.023</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Biological and medical sciences Critical care Critical Illness - therapy education programs Education, Medical, Continuing Educational program energy requirements enteral feeding fasting Feeding. Feeding behavior Female Fundamental and applied biological sciences. Psychology Gastroenterology and Hepatology gender Humans Intensive Care Units Length of Stay Male Middle Aged Nutrition Assessment Nutrition Therapy - methods nutritional adequacy Nutritional Requirements Nutritional Sciences - education Nutritional therapy nutritive value patients Prospective Studies Vertebrates: anatomy and physiology, studies on body, several organs or systems |
| title | Education program on medical nutrition and length of stay of critically ill patients |
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