[The quality of the care in parenteral nutrition: the benefits after the incorporation of a nutritional support team].
OBJECTIVE
The purpose of the study was to analyze the quality of the prescription and follow-up of the total parenteral nutrition (PNT) before and after the incorporation of a nutritional support team (NST).


METHODS
A random sample of 96 patients was selected retrospectively, with 48 prior to the incorporation of the NST (the Non-NST group) and 48 after its incorporation (the NST group), to whom TPN was prescribed. The following points were assessed: 1. The existence of a minimum analytical and nutritional assessment, prior to the incorporation of TPN; 2. The follow-up of the same.


RESULTS
The average duration of TPN per patient was 13.8 days without differences between the two groups. There is a written record of the weight and height in 15% and 10% of cases, respectively, in the Non-NST group as opposed to 100% and 99% in the NST group (p < 0.0001). Prior to the incorporation of the NST, the nutritional requirement was not verified in any patients (0%) as opposed to 97% afterwards. Statistically significant differences were detected in the measurement of albumin prior to the start of TPN (p < 0.01). During the analytical follow-up, statistically significant differences were detected in the measurement of: blood tests (p < 0.05); basic biochemistry (p < 0.01); general biochemistry, magnesium, zinc, pre-albumin, transferrin and nitrogen balance (p < 0.0001). In the TPN follow-up, the Non-NST group did not change any of the components contained in it (in terms of volume, macro or micronutrients) in 81% of patients, while 17% had one change and 2% had 2 or more changes, as opposed to 27%, 42% and 31%, respectively in the NST group (p < 0.0001). There were no significant differences in metabolic complications between the two groups.


CONCLUSIONS
The implementation of a nutritional support team in charge of the prescription and follow-up of TPN has notably improved the quality of these follow-up studies.
Servicio de Endocrinología y Nutrición, Complejo Hospitalario Carlos Haya, Málaga, España. gof@arrakis.es
G
G
Olveira Fuster
I
I
Mancha Doblas
S
S
González-Romero
M E
ME
Goiburu
A
A
Muñoz Aguilar
J M
JM
García Almeida
D016009:Chi-Square Distribution; D005500:Follow-Up Studies; D006801:Humans; D010289:Parenteral Nutrition, Total / Q000592:standards* / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000592:standards* / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013030:Spain; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires