دورية أكاديمية
Optimizing the nutrition support care model: Analysis of survey data.
| العنوان: | Optimizing the nutrition support care model: Analysis of survey data. |
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| المؤلفون: | Mundi MS; Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA., Mechanick JI; The Marie-Josee and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart and the Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Mohamed Elfadil O; Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA., Patel JJ; Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Bonnes SL; Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA., Blackmer AB; American Society for Parenteral and Enteral Nutrition, Silver Spring, Maryland, USA.; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado, USA., Christian VJ; Division of Pediatric Gastroenterology, University of Minnesota, Minneapolis, Minnesota, USA., Hennessy SA; Division of Burn, Trauma, Acute and Critical Care Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA., Hurt RT; Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA., Jain A; Division of Pediatric Gastroenterology, Saint Louis University, Saint Louis, Missouri, USA., Kaspar MB; Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA., Katz J; Division of Gastroenterology and Hepatology, New York University Langone Medical Center, New York, New York, USA., Labossiere R; Birmingham/Atlanta Geriatric Reserach, Education, and Clinical Center, Veterans Integrated Service Network 07, Duluth, Georgia, USA., Limketkai BN; Division of Digestive Diseases, UCLA School of Medicine, Los Angeles, California, USA., McCarthy PJ; Division of Cardiovascular Critical Care, West Virginia University School of Medicine, Morgantown, West Virginia, USA., Morrison CA; Division of Trauma and Critical Care, Central Michigan University College of Medicine, Pleasant, Michigan, USA., Newberry C; Division of Gastroenterology, Innovative Center for Health and Nutrition in Gastroenterology (ICHANGE), Weill Cornell Medical Center, New York, New York, USA., Pimiento JM; Department of GI Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA., Rosenthal MD; Division of Trauma and Acute Care Surgery, University of Florida, Gainesville, Florida, USA., Taylor B; Department of Research for Patient Care Services, Barnes-Jewish Hospital, St. Louis, Missouri, USA., McClave SA; Division of Gastroenterology, Hepatology, and Nutrition, School of Medicine, University of Louisville, Louisville, Kentucky, USA. |
| مؤلفون مشاركون: | ASPEN Physician Engagement Committee |
| المصدر: | JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2022 Sep; Vol. 46 (7), pp. 1709-1724. Date of Electronic Publication: 2022 Feb 16. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley Country of Publication: United States NLM ID: 7804134 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1941-2444 (Electronic) Linking ISSN: 01486071 NLM ISO Abbreviation: JPEN J Parenter Enteral Nutr Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2018- : [Hoboken, NJ] : Wiley Original Publication: Thorofare, N. J., Slack. |
| مواضيع طبية MeSH: | Malnutrition*/prevention & control , Malnutrition*/therapy , Nutrition Therapy*, Humans ; Nutritional Support/methods ; Patient Care Team ; Surveys and Questionnaires ; United States |
| مستخلص: | Background: Malnutrition 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. Methods: This survey assessed demographics of NSTs, factors contributing to the success of NSTs, elements of nutrition education, and other barriers to professional growth. Results: Of 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. Conclusion: Core 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. (© 2022 American Society for Parenteral and Enteral Nutrition.) |
| References: | Cederholm T, Jensen GL, Correia MITD, et al. GLIM criteria for the diagnosis of malnutrition-a consensus report from the global clinical nutrition community. Clin Nutr. 2019;38(1):1-9. doi:10.1016/j.clnu.2018.08.002. Doley J, Phillips W. Coding for malnutrition in the hospital: does it change reimbursement? Nutr Clin Pract. 2019;34(6):823-831. doi:10.1002/ncp.10426. Hudson L, Chittams J, Griffith C, Compher C. Malnutrition identified by Academy of Nutrition and Dietetics/American Society for parenteral and enteral nutrition is associated with more 30-day readmissions, greater hospital mortality, and longer hospital stays: a retrospective analysis of nutrition assessment data in a major medical center. JPEN J Parenter Enteral Nutr. 2018;42(5):892-897. doi:10.1002/jpen.1021. Guenter P, Abdelhadi R, Anthony P, et al. Malnutrition diagnoses and associated outcomes in hospitalized patients: United States. Nutr Clin Pract. 2018;36(5):957-969. doi:10.1002/ncp.10771. Guerra RS, Sousa AS, Fonseca I, et al. Comparative analysis of undernutrition screening and diagnostic tools as predictors of hospitalisation costs. J Hum Nutr Diet. 2016;29(2):165-173. doi:10.1111/jhn.12288. Isabel TD, Correia M, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr. 2003;22(3):235-239. doi:10.1016/S0261-5614(02)00215-7. Eriksen MK, Crooks B, Baunwall SMD, Rud CL, Lal S, Hvas CL. Systematic review with meta-analysis: effects of implementing a nutrition support team for in-hospital parenteral nutrition. Aliment Pharmacol Ther. 2021;54(5):560-570. doi:10.1111/apt.16530. Nightingale J. Nutrition support teams: how they work, are set up and maintained. Frontline Gastroenterol. 2010;1(3):171-177. doi:10.1136/fg.2009.000224. Tignanelli CJ, Sheetz KH, Petersen A, et al. Utilization of intensive care unit nutrition consultation is associated with reduced mortality. JPEN J Parenter Enteral Nutr. 2020;44(2):213-219. doi:10.1002/jpen.1534. Adams KM, Kohlmeier M, Zeisel SH. Nutrition education in U.S. medical schools: latest update of a national survey. Acad Med. 2010;85(9):1537-1542. doi:10.1097/ACM.0b013e3181eab71b. Chung M, van Buul VJ, Wilms E, Nellessen N, Brouns FJPH. Nutrition education in European medical schools: results of an international survey. Eur J Clin Nutr. 2014;68(7):844-846. doi:10.1038/ejcn.2014.75. Daley BJ, Cherry-Bukowiec J, Van Way CW, et al. Current status of nutrition training in graduate medical education from a survey of residency program directors a formal nutrition education course is necessary. J Parenter Enteral Nutr. 2016;40(1):95-99. doi:10.1177/0148607115571155. Trujillo EB, Claghorn K, Dixon SW, et al. Inadequate nutrition coverage in outpatient cancer centers: results of a national survey. J Oncol. 2019;2019:e7462940. doi:10.1155/2019/7462940. Siu AHY, Carey S, Jones L, Morton RL, Koh CE. Detailed analysis of in-hospital costs for adult patients with type III intestinal failure: a single-center study with global implications. JPEN J Parenter Enteral Nutr. Accepted manuscript. Published online April 30, 2021. doi:10.1002/jpen.2136. Afshari A, De Hert S. Pitfalls of clinical practice guidelines in the era of broken science: let's raise the standards. Eur J Anaesthesiol. 2018;35(12):903-906. doi:10.1097/EJA.0000000000000892. Cawood AL, Walters ER, Smith TR, Sipaul RH, Stratton RJ. A review of nutrition support guidelines for individuals with or recovering from COVID-19 in the community. Nutrients. 2020;12(11):3230. doi:10.3390/nu12113230. Holt B, Graves C, Faraklas I, Cochran A. Compliance with nutrition support guidelines in acutely burned patients. Burns. 2012;38(5):645-649. doi:10.1016/j.burns.2011.12.002. Irving SY, Guenter P, Mehta NM. Incorporating the latest pediatric nutrition support guidelines into clinical practice. Nursing. 2019;49(2):38-44. doi:10.1097/01.NURSE.0000552699.27631.88. Kyle UG, Lucas LA, Mackey G, et al. Implementation of nutrition support guidelines may affect energy and protein intake in the pediatric intensive care unit. J Acad Nutr Diet. 2016;116(5):844-851.e4. doi:10.1016/j.jand.2016.01.005. McCall ME, Adamo A, Latko K, Rieder AK, Durand N, Nathanson T. Maximizing nutrition support practice and measuring adherence to nutrition support guidelines in a canadian tertiary care ICU. J Intensive Care Med. 2018;33(3):209-217. doi:10.1177/0885066617749175. Mechanick JI, Bergman DA, Braithwaite SS, Palumbo PJ; American Association of Clinical Endocrinologists Ad Hoc Task Force for Standardized Production of Clinical Practice Guidelines. American Association of Clinical Endocrinologists protocol for standardized production of clinical practice guidelines. Endocr Pract. 2004;10(4):353-361. doi:10.4158/EP.10.4.353. Mechanick JI, Camacho PM, Cobin RH, et al; American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists Protocol for standardized production of clinical practice guidelines-2010 update. Endocr Pract. 2010;16(2):270-283. doi:10.4158/EP.16.2.270. Mechanick JI, Camacho PM, Garber AJ, et al. American Association of Clinical Endocrinologists and American College of Endocrinology Protocol for standardized production of clinical practice guidelines, algorithms, and checklists-2014 Update and the AACE G4G Program. Endocr Pract. 2014;20(7):692-702. doi:10.4158/EP14166.PS. Mechanick JI, Pessah-Pollack R, Camacho P, et al. American Association of Clinical Endocrinologists and American College of Endocrinology Protocol for standardized production of clinical practice guidelines, algorithms, and checklists-2017 update. Endocr Pract. 2017;23(8):1006-1021. doi:10.4158/EP171866.GL. Pawlson G, Scholle SH, Renner P. Pitfalls of converting practice guidelines into quality measures. JAMA. 2004;292(11):1301-1302. doi:10.1001/jama.292.11.1301-a. Tinetti ME, Bogardus ST, Agostini JV. Potential pitfalls of disease-specific guidelines for patients with multiple conditions. N Engl J Med. 2004;351(27):2870-2874. doi:10.1056/NEJMsb042458. Walter LC, Davidowitz NP, Heineken PA, Covinsky KE. Pitfalls of converting practice guidelines into quality measures: lessons learned from a VA performance measure. JAMA. 2004;291(20):2466-2470. doi:10.1001/jama.291.20.2466. Mechanick JI, Carbone S, Dickerson RN, et al. Clinical nutrition research and the COVID-19 pandemic: a scoping review of the ASPEN COVID-19 task force on nutrition research. JPEN J Parenter Enteral Nutr. 2021;45(1):13-31. doi:10.1002/jpen.2036. Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: a review. JAMA Surg. 2017;152(3):292-298. doi:10.1001/jamasurg.2016.4952. Mundi MS, Pattinson A, McMahon MT, Davidson J, Hurt RT. Prevalence of home parenteral and enteral nutrition in the United States. Nutr Clin Pract. 2017;32(6):799-805. doi:10.1177/0884533617718472. Ockenga J, Freudenreich M, Zakonsky R, Norman K, Pirlich M, Lochs H. Nutritional assessment and management in hospitalised patients: implication for DRG-based reimbursement and health care quality. Clin Nutr. 2005;24(6):913-919. doi:10.1016/j.clnu.2005.05.019. Ferguson ML, Bauer J, Gallagher B, Capra S, Christie DRH, Mason BR. Validation of a malnutrition screening tool for patients receiving radiotherapy. Australas Radiol. 1999;43(3):325-327. doi:10.1046/j.1440-1673.1999.433665.x. Nutritional and functional screening - requirement. Accessed December 19, 2020. 43(3):325-327. https://www.jointcommission.org/standards/standard-faqs/critical-access-hospital/provision-of-care-treatment-and-services-pc/000001652/. Martindale R, Patel JJ, Taylor B, Warren M, McClave SA, Martindale R, Patel JJ, Taylor B, Arabi YM, Warren M & McClave SA Nutrition therapy in critically Ill patients with Coronavirus Disease 2019. J Parenter Enteral Nutr. 2020;44(7):1174-1184. http://dx.doi.org/10.1002/jpen.1930. Barazzoni R, Bischoff SC, Krznaric Z, Pirlich M, Singer P. Espen expert statements and practical guidance for nutritional management of individuals with sars-cov-2 infection. Clin Nutr. 2020;39(6):1631-1638. doi:10.1016/j.clnu.2020.03.022. Pratt C, Brown A, Shilpy D, et al. Setting the agenda for nutrition research in heart, lung, and blood diseases and sleep disorders: a review of the literature, gaps and opportunities. Curr Dev Nutr. 2021;5(suppl 2):1269. doi:10.1093/cdn/nzab056_007. Tyler R, Barrocas A, Guenter P. ASPEN value project: what the field needs to move forward. Nutr Clin Pract. 2019;34(6):800-801. doi:10.1002/ncp.10424. Morton SMB, Bandara DK, Robinson EM, Carr PEA. In the 21st century, what is an acceptable response rate? Aust N Z J Public Health. 2012;36(2):106-108. doi:10.1111/j.1753-6405.2012.00854.x. Brown M, Rosenthal M, Yeh DD. Implementation science and nutrition: from research to practice. Nutr Clin Pract. 2021;36(3):586-597. doi:10.1002/ncp.10677. |
| معلومات مُعتمدة: | R01 DK131136 United States DK NIDDK NIH HHS |
| فهرسة مساهمة: | Keywords: chronic care model; malnutrition; medical economics; medical nutrition; nutrition; nutrition support; nutrition support teams; reimbursement |
| تواريخ الأحداث: | Date Created: 20220118 Date Completed: 20220913 Latest Revision: 20230701 |
| رمز التحديث: | 20230701 |
| DOI: | 10.1002/jpen.2326 |
| PMID: | 35040154 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1941-2444 |
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| DOI: | 10.1002/jpen.2326 |