• Title/Summary/Keyword: Nutritional support team

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Degree of Nutritional Support and Nutritional Status in MICU Patients (내과계 중환자의 영양공급 현황 및 영양상태 변화)

  • Chi, Soo-Na;Ko, Jea-Young;Lee, Su-Ha;Lim, Eun-Hwa;Kown, Kuk-Hwan;Yoon, Mi-Seon;Kim, Eun-Sook
    • Journal of Nutrition and Health
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    • v.44 no.5
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    • pp.384-393
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    • 2011
  • The objective of this study was to determine the nutritional support in patients treated in medical intensive care units (MICUs) by evaluating the extent of current nutritional support using the patient care plan and considering the association between nutritional status and the amount of nutrition supplied. From April to December 2010, 114 patients (age ${\qeq}$ 18 years) admitted to the MICU and who underwent nutritional support for > 5 days were included. Descriptive statistics showed that the 114 patients received nutritional support within 1.2 ${\pm}$ 0.7 days and for 16.2 ${\pm}$ 11.7 days in the MICUs. The total delivered/required caloric ratio was 81.08 ${\pm}$ 27.31%, and the protein ratio was 80.32 ${\pm}$ 28.93%. Patients who received > 80% of required calories and protein showed improved nutritional status (p < 0.05). The results showed that adequate nutritional support is crucial to critically ill patients. We suggest early nutritional screening using simple tools such as periodic monitoring and management to recalculate nutritional status and nutritional requirements and nutritional support using a multidisciplinary method. Systematic nutritional support teams are needed to provide adequate nutritional support for patients in the MICU.

How to Manage the Pediatric Nutritional Support Team: Updates

  • Yang, Hye Ran
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.15 no.2
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    • pp.79-84
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    • 2012
  • Pediatric patients in hospital are at risk of malnutrition at admission and even during their hospitalization. Although the concept of nutritional support team (NST) was introduced to hospitals for optimal nutritional care since 1960s and the benefits of pediatric NST have been proven by many studies and reports in terms of patient clinical outcome and cost saving, the pediatric NST is not widespread yet. The pediatric NST composed of pediatricians, dieticians, pharmacist, and nutrition support nurses as core members dedicated to nutritional care in children should be independent of central NST or other disciplines, but closely cooperate with other teams in hospitals. There is no doubt that a multidisciplinary NST is an effective way to provide appropriate nutritional support to an individual patient. Therefore, the implementation of the pediatric NST in hospitals should be recommended to provide optimum nutritional support including enteral tube feeding and parenteral nutrition and to assess pediatric patients at risk of malnutrition.

Managing Pediatric Nutritional Support Team in Hospital (소아 영양지원팀 운영 및 관리의 실제)

  • Yang, Hye Ran
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.sup1
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    • pp.37-40
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    • 2009
  • Nutritional support team (NST) is a multidisciplinary group of nutrition professionals with interest and expertise in the evaluation and management of malnutrition and nutrition-related problems in hospital. The goal of NST is providing optimal nutrition to patients who need enteral and parenteral nutrition. Recently, NST is set up in some hospitals in Korea. However, until now, pediatric NST is not established in most hospitals. Because children admitted to hospital are at risk of malnutrition, NST is required to provide effective nutritional management for pediatric patients.

Effect of Nutrition Support Team Management - Focusing on Medical Intensive Care Unit Patients - (영양집중지원에 따른 결과 비교 - 내과계 중환자실 대상으로 -)

  • Im, Waon Sun;Lee, Yun Mi
    • Journal of Korean Critical Care Nursing
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    • v.11 no.3
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    • pp.108-119
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    • 2018
  • Purpose : This study evaluated the nutritional status and effect of nutritional support team (NST) management in critically ill patients. Methods : From January 2015 to August 2017, the study retrospectively investigated 128 patients aged above 19 years admitted to a medical intensive care unit (MICU). The patients were divided into two groups: NST (n=65) and non-NST (n=63) groups. Nutritional status, classification of bedsore risks, incidence rate of bedsore and clinical outcomes were compared. Results : The study found a higher rate of the use of enteral nutrition in the NST group (${\chi}^2=45.60$, p < .001). The prescription rate of parenteral nutrition (PN) was found to be lower in the NST group (4.6%) compared to the non-NST group (60.3%). There was a higher PN of total delivered/required caloric ratio in the NST, compared to the non-NST, group (${\chi}^2=3.33$, p=.025). There were significant differences for higher albumin levels (t=2.50, p=.014), higher total protein levels (t=2.94, p=.004), and higher proportion of discharge with survival rates (${\chi}^2=18.26$, p < .001) in the NST group. Conclusions : Providing NST management to critically ill patients showed an increase in the nutrition support. Further, to achieve effective clinical outcomes, measures such as nutrition education and continuous monitoring and management for the provision of nutritional support by the systemic administration of a nutritional support team should be considered.

Optimizing Nutrition Support in Cancer Care

  • Menon, Kavitha Chandrasekhara
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2933-2934
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    • 2014
  • Involvement of a multidisciplinary team in cancer care may have added benefits over the existing system of patient management. A paradigm shift in the current patient management would allow more focus on nutritional support, in addition to clinical care. Malnutrition, a common problem in cancer patients, needs special attention from the early days of cancer care to improve quality of life and treatment outcomes. Patient management teams with trained oncology dietitians may provide quality personalized nutritional care to cancer patients.

Evaluation and Treatment of Malnutrition and Associated Gastrointestinal Complications in Children with Cerebral Palsy

  • Trivic, Ivana;Hojsak, Iva
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.2
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    • pp.122-131
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    • 2019
  • The majority of children with cerebral palsy (CP) have feeding difficulties and are especially prone to malnutrition. The early involvement of a multidisciplinary team should aim to prevent malnutrition and provide adequate nutritional support. Thorough nutritional assessment, including body composition, should be a prerequisite for the nutritional intervention. As in typically-developed children nutritional support should start with dietary advice and the modification of oral feeding, if safe and acceptable. However, for prolonged feeding, in the presence of unsafe swallowing and inadequate oral intake, enteral nutrition should be promptly initiated and early gastrostomy placement should be evaluated and discussed with parents/caregivers. Gastrointestinal problems (oropharyngeal dysfunction, gastroesophageal disease, and constipation) in children with CP are frequent and should be actively detected and adequately treated as they can further worsen the feeding process and nutritional status.

The Effect of Total Parenteral Nutrition on Hospitalized Patients according to Nutritional Status (입원 환자의 영양상태에 따른 TPN(Total Parenteral Nutrition) 공급 현황 및 TPN 공급 효과 비교)

  • 배제헌;김순경
    • Korean Journal of Community Nutrition
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    • v.8 no.4
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    • pp.574-583
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    • 2003
  • The purpose of this study was to investigate the anthropometry, biochemical parameters and electrolytes concentrations of the Total Parenteral Nutrition (TPN) patients according to their nutritional status at the time of admission. Thirty-three patients in the Intensive Care Unit at S University Hospital were the subjects of this study. Their nutritional status was classified as At-risk I (Mild PCM, n = 13), At - risk II (Moderate PCM, n = 9) and At-risk III (Marasmus + kwashiorkor + severe PCM, n = 11) . Anthropometeric, biochemical and dietary assessments were performed. The Patients intake of calories (75.02%) and protein (53.15%) was insufficient compare with Korean RDA requirements. The body weight and the Body Mass Index (BMI) in the At-risk III group were significantly lower than in the other groups. The percentage of body weight loss and change of body weight (kg) were significantly higher than in the other groups. The subjects were malnourished as indicated by nutritional related parameters such as serum total protein, albumin, total lymphocyte count (TLC), hemoglobin and hematocrit. Serum total protein, albumin and TLC levels were lower at the time of admission before TPN administration. But after TPN administration, they increased. The electrolyte concentrations did not show any differences following TPN administration. The nutritional status of the patients could be affect by the duration of TPN administration and the number of days of the patients hospitalization. The patients who require nutritional support need the continuous follow-up care and monitoring by a nutritional support team. (Korean J Community Nutrition 8(4) : 574-583, 2003)

Application and Efficacy Evaluation of Nutritional Screening Tool (영양부족 환자의 조기발견을 위한 선별검사의 적용 및 효용성 평가)

  • Nam, Gung-Hwan
    • Journal of Korea Association of Health Promotion
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    • v.4 no.1
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    • pp.1-11
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    • 2006
  • "본 논문은 대한외과학회지 2006년 제70권제1호에 실렸던 논문으로 대한외과학회 편집위원회 승인을 득하고 본 협회지에 게재함. Purpose: Malnutrition has been frequently reported for patients on their admission to the hospital and it has been associated with an increase in morbidity, mortality and the length of the hospital stay. Although a number of screening tools have been developed to identify those patients at risk for malnutrition, there is no' gold standard' for defining malnutrition and the malnourished patients remain largely unrecognized. The aim of this study is to evaluate the efficacy of a nutritional screening tool for use in Dankook University Hospital. Methods Nutritional evaluation was performed for 53 patients who were admitted to the department of surgery and internal medicine between October and December 2004. The screening tool was completed by the ward nurse and the nutritional support team nurse on the same patients within24 hours of admission. The nutritional support team nurse performed the full assessment. The screening sheet included 4 questions regarding body mass index, recent unintentional weight loss, food intake and disease severity. Each answer was scored and a total of 5 was tested as the criterion fey malnutrition. The full assessment included current body weight, recent weight loss, triceps skinfold thickness, mid-arm muscle circumference, serum albumin)in and total lymphocyte count. Malnutrition was defined by 3 or more values below the reference values. The reliability of the screening tool was assessed using kappa statistic. Sensitivity, specificity and accuracy were calculated to evaluate the validity of the screening tool. The receiver operating characteristic(ROC) curve was drawn to choose a cutoff valve that maximizes sensitivity and specificity. Results' The level of agreement between the ward nurse and the NST nurse was good for BMI and food intake and moderate for weight loss and disease severity. The full assessment identified7 patients(13.2%) as malnourished. The screening sheet had a sensitivity of 86% and a specificity of 80%. According to the ROC curve, a score of 5 points provided the best validity. Conclusion The nutritional screening tool is reliable when completed by different observers and it is valid for nutritional assessment.

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Clinical Significance of the Nutritional Support Team for Preterm Infants in a Neonatal Intensive Care Unit (신생아중환자실에 입원한 미숙아에서 영양지원팀 활동의 임상적 의의)

  • Yang, Hye-Ran;Choi, Chang-Won;Kim, Beyong-Il;Seo, Jeong-Kee;Choi, Su-Ahn;Kim, So-Yeon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.39-45
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    • 2009
  • Purpose: Preterm infants are very susceptible to malnutrition because of a lack of storage of nutrients, immature digestion and metabolism, and accompanying diseases associated with prematurity. The purpose of this study was to evaluate the effects of nutritional support by the pediatric nutritional support team (pNST) on the clinical course of preterm infants in the neonatal intensive care unit (NICU). Methods: Between July 2003 and July 2006, 48 preterm infants who were admitted to the NICU at Seoul National University Bundang Hospital were included. The subjects were divided into the following two subgroups according to the presence of NST activity; pre-NST group (n=23) and NST group (n=25). Hospital records were reviewed retrospectively. Results: Forty-eight preterm babies were included (M:F=27:21; gestational age, 25~33 weeks). A dietician, pharmacists, or the pNST participated in the prescription of total parenteral nutrition (TPN) more rapidly in the NST group (p=0.000). The fasting periods and TPN administration periods were significantly decreased in the NST group compared to the pre-NST group (p=0.017 & p=0.001, respectively). The doses of calories, protein, and lipids administered via TPN were significantly increased in the NST group compared to the pre-NST group (p=0.016, p=0.000, and p=0.000, respectively). The total period on antibiotic therapy was significantly decreased in the NST group compared to the pre-NST group (p=0.007). Conclusion: Because nutritional support by the pNST is of benefit to the clinical course of preterm infants in the NICU, the pNST should recommend to improve the nutritional status and clinical outcome of preterm infants.

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A comparison of nutritional status by intensive nutritional support in enteral nutrition patients (경장영양을 시행한 환자에서 영양집중지원에 따른 영양상태 비교)

  • Kim, Bo-Hee;Kim, Hyesook;Kwon, Oran
    • Journal of Nutrition and Health
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    • v.51 no.2
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    • pp.132-139
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    • 2018
  • Purpose: The aim of this study was to determine the effects of nutritional intervention focused on a Nutrition Support Team (NST) in patients receiving enteral nutrition (EN) in general hospital wards. Methods: The electronic medical records of 95 adult patients admitted in C university hospital and received EN supply for more than 3 days at a general ward were analyzed retrospectively. The subjects were classified into the intervention group (n = 40) and non-intervention group (n = 55). Results: The calorie support rate (%) and protein support rate (%) increased significantly only in the intervention group after 2 weeks compared to the rate upon admission. The serum albumin levels increased in the intervention group after 2 weeks compared to the levels at admission, but decreased in the non-intervention group. The glucose levels decreased only in the intervention group compared to that at admission. Conclusion: The nutritional status of the patients was improved by the proper planning of nutrition management from the beginning of hospitalization and systematically managing the nutrition intervention of the NST.