Optimizing the nutrition support care model: Analysis of survey data.
Optimizing the nutrition support care model: Analysis of survey data.
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优化营养支持护理模式：调查数据分析。
DOI：
10.1002/jpen.2326
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Limketkai,Be
中科院分区：
文献类型：
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作者：
Mundi,ManpreetS;Mechanick,JeffreyI;MohamedElfadil,Osman;Patel,JayshilJ;Bonnes,SaraL;Blackmer,AllisonB;Christian,VikramJ;Hennessy,SaraA;Hurt,RyanT;Jain,Ajay;Kaspar,MatthewB;Katz,Jennifer;Labossiere,Reginald;Limketkai,Be
背景：尽管营养不良的患病率很高，临床结果也很差，但人们对营养不良的认识和诊断都不足。尽管有证据表明营养支持团队（NST）管理的并发症发生率较低，但临床营养专家，特别是医生参与高危营养不良患者的护理仍然很低。为了促进解决方案，一项调查旨在阐明nst和医生参与的性质，并确定对新型营养支持护理模式的需求。方法本调查评估了NSTs的人口统计学特征、影响NSTs成功的因素、营养教育的要素以及职业发展的其他障碍。结果在255名被调查者中，分析了235份完整的问卷。受访者的地理分布与美国的人口集中相关（r= 90.8%,p< 0.0001）。大多数回应的医生（46/57;80.7%）报告是NSTs的成员，而56.5%（88/156）的营养师报告是NSTs的成员。在没有在NST执业的人中（N= 81/235, 34.4%）， 12.3%（10/81）报告曾有一名NST在其所在机构工作，但已被解散。对于nst，财务问题最为常见（115/235,48.9%），其次是领导（72/235,30.6%）和医疗保健专业人员（HCP）兴趣（55/235,23.4%）。大多数受访者（173/235;73.6%）希望接受营养方面的额外培训，但报告受保护时间不足、旅行能力不足，或缺乏管理人员或其他卫生保健人员的支持。结论：本次调查得出的核心行动集中在正规化医生角色、增加跨学科营养支持专业知识、利用具有成本效益的营养不良筛查以及实施干预方案。其他行动包括增加临床实践、教育和研究的资金，所有这些都在扩大的实用营养支持护理模式的投资组合中。
BackgroundMalnutrition is underrecognized and underdiagnosed, despite high prevalence rates and associated poor clinical outcomes. The involvement of clinical nutrition experts, especially physicians, in the care of high‐risk patients with malnutrition remains low despite evidence demonstrating lower complication rates with nutrition support team (NST) management. To facilitate solutions, a survey was designed to elucidate the nature of NSTs and physician involvement and identify needs for novel nutrition support care models.MethodsThis survey assessed demographics of NSTs, factors contributing to the success of NSTs, elements of nutrition education, and other barriers to professional growth.ResultsOf 255 respondents, 235 complete surveys were analyzed. The geographic distribution of respondents correlated with population concentrations of the United States (r= 90.8%,p< .0001). Most responding physicians (46/57; 80.7%) reported being a member of NSTs, compared with 56.5% (88/156) of dietitians. Of those not practicing in NSTs (N= 81/235, 34.4%), 12.3% (10/81) reported an NST was previously present at their institution but had been disbanded. Regarding NSTs, financial concerns were common (115/235; 48.9%), followed by leadership (72/235; 30.6%), and healthcare professional (HCP) interest (55/235; 23.4%). A majority (173/235; 73.6%) of all respondents wanted additional training in nutrition but reported insufficient protected time, ability to travel, or support from administrators or other HCPs.ConclusionCore actions resulting from this survey focused on formalizing physician roles, increasing interdisciplinary nutrition support expertise, utilizing cost‐effective screening for malnutrition, and implementing intervention protocols. Additional actions included increasing funding for clinical practice, education, and research, all within an expanded portfolio of pragmatic nutrition support care models.