Indicadores de qualidade em terapia nutricional no contexto de cuidados intensivos em um hospital de ensino brasileiro

Rosa, Teresa Cristina Abranches; Raslan, Mariana; Souza, Albert Schiaveto de; Gielow, Karine de Cássia Freitas

doi:10.20435/inter.v20i3.1759

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Artigos • Interações (Campo Grande) 20 (3) • Jul-Sep 2019 • https://doi.org/10.20435/inter.v20i3.1759 copiar

Indicadores de qualidade em terapia nutricional no contexto de cuidados intensivos em um hospital de ensino brasileiro

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo:

O tema abordado pelo estudo foi indicadores de qualidade em terapia nutricional. O objetivo foi avaliar a qualidade da terapia nutricional em uma unidade de terapia intensiva para adultos em um hospital universitário brasileiro. Realizou-se a aplicação de dez indicadores de qualidade selecionados de uma lista elaborada pela Força Tarefa de Nutrição Clínica do International Life Sciences Institute (ILSI-Brasil). Observou-se que o uso de indicadores de qualidade de terapia nutricional permitiu a identificação de processos em conformidade e em não-conformidade, que ainda precisam de ajustes adicionais.

Palavras-chave:
terapia nutricional; indicadores de qualidade em assistência à saúde; nutrição enteral; nutrição parenteral; gestão da qualidade

Variable	N	%	Mean ± SD
Sex Males Females	56 39	56 39	-
Age (years) Adults Older adults^* * Elderly: ≥60 years; SD: standard deviation; ENT: enteral nutrition therapy; PNT: parenteral nutrition therapy.	- 38 57	- 40 60	63.14 ± 19.51
Diagnosis Pneumonia Sepsis AIDS Other	29 18 14 34	29 18 14 34	-
Length of hospital stay (days)	-	-	16.56 ± 16.00
Clinical outcome Discharge Transfer Death Extended ICU stay	23 89 1	2.10 3.16 93.68 1.05	-
Nutrition therapy ENT + PNT PNT ENT	5 13 90	5.26 13.68 94.73	-

Indicator¹ 1 Waitzberg (2008).	Equation Formula¹ 1 Waitzberg (2008).	Result (%)	Target rate
Frequency of nutritional screening among inpatients	$\frac{Nutritional screenings per 24 h \times 100}{Total admissions}$	0	>80%
Frequency of diarrhea episodes among patients on ENT	$a) \frac{Patients with diarrhea during ENT \times 100}{Patients on ENT}$	16.84	<10%
Frequency of diarrhea episodes among patients on ENT	$b) \frac{Days with diarrhea during ENT \times 100}{Total days on ENT}$	2.19*	<10%
Frequency of accidental dislodgment of nutrition catheter among patients on ENT	$\frac{Accidental dislodgment of nutrition catheter \times 100}{Patients on ENT \times days with enteral catheter}$	0.0026*	<5%
Frequency of nutrition catheter obstruction among patients on ENT	$a) \frac{Obstructed enteral catheters \times 100}{Patients on ENT \times days with enteral catheter}$	0*	<5%
	$b) \frac{Obstructed enteral catheters removed \times 100}{Patients on ENT \times days with enteral catheter}$	0*	<5%
Frequency of fasting longer than 24 h among patients on ENT	$\frac{Patients fasting for more than 24 h \times 100}{Patients on NT}$	55.79	≤12%
Frequency of impaired glucose levels among patients on ENT and PNT	$a) \frac{Hyperglycemic patients \times 100}{Patients on ENT, PNT, or both}$	68.42*	70-80%¹ 1 Waitzberg (2008).
	$b) \frac{Hypoglycemic patients \times 100}{Patients on ENT, PNT, or both}$	32.63	5.1-6.9%¹ 1 Waitzberg (2008).
Frequency of measurements of estimated EE and protein needs among patients on NT	$\frac{Patients on NT with measured EE \times 100}{Patients on ENT}$	68.42	≥80%
Frequency of CVC infection among patients on PNT	$\frac{Episodes of CVC \inf ection \times 1000}{Days on catheter}$	6.49*	<10‰²
Frequency of ENT nonconformity to guidelines	$\frac{Patients on ENT noncompliant with guidelines \times 100}{Patients on ENT}$	20.00	<13.5%
Frequency of SGA among patients on NT	$\frac{Patients on NT subject to SGA \times 100}{Patients on ENT}$	0	>75%

Universidade Católica Dom Bosco Av. Tamandaré, 6000 - Jd. Seminário, 79117-900 Campo Grande- MS - Brasil, Tel./Fax: (55 67) 3312-3373/3377 - Campo Grande - MS - Brazil
E-mail: suzantoniazzo@ucdb.br

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[1] Teresa Cristina Abranches Rosa - Master's Degree in Metabolism and Nutrition by the Post-Graduate Program in Health and Development in the Center-West Region (UFMS). Specialization by the Multiprofessional Health Residency Program - Attention to the Critical Patient, from UFMS, Maria Aparecida Pedrossian University Hospital (HUMAP). Graduation in Nutrition by the Federal University of Viçosa (UFV). Nutritionist at UFMS, tutor in the Multiprofessional Health Residency Program - UFMS /HUMAP/EBSERH Critical Patient Care, tutor in the Multiprofessional Residency Program in Integrated Continuing Care, Area of Concentration: Health Care of the Elderly (PREMUS CCI) UFMS / HOSPITAL SÃO JULIÃO / ESP / SES. Professor at Nutrition Course at Campo Grande College (FCG). E-mail:teresacristinaar@yahoo.com.br, Orcid:http://orcid.org/0000-0002-9990-6560