title: Impact of a computerized information system on quality of nutritional support in the ICU.
abstract: OBJECTIVE
  In intensive care units (ICUs), patient outcome depends on quality of nutritional support. We investigated the effect of computerized information systems (CISs) on quality of nutritional support by comparing two ICUs with or without CIS and burned patients before and after CIS implementation.
  
  
  METHODS
  Part 1 was a 2-wk prospective survey in two units of a surgical ICU: unit A (11 beds) without CIS and unit B (four beds) with CIS. Part 2 consisted of two 18-mo periods in burn patients before and after CIS implementation. Nurses and doctors belonged to the same team; procedures were identical. A computer page was configured to retrieve data related to nutritional support.
  
  
  RESULTS
  A total of 1313 ICU days were analyzed in 109 patients. Patients' characteristics were similar in parts 1 and 2. In part 1, nutritional support was required 38% of days. Nutritional route was similar but data were more frequently missing in unit A. Energy delivery was higher with CIS but below target values in both units (31+/-11% of target in unit A, 77+/-4% in unit B). Computations were incomplete and time consuming for unit A versus B (11+/-2 versus 2+/-1 min/patient, P<0.0001). In part 2, in the 54 burn patients, use of postpyloric feeding tubes and energy delivery increased with CIS, resulting in less weight loss.
  
  
  CONCLUSIONS
  Computerized information systems favored standardization of nutritional care and monitoring, thus decreasing time required for writing and computations. Follow-up was improved and nutrient delivery was closer to target values, thus increasing quality of care. In burn patients, the better data visibility was associated with a significant improvement in nutrient delivery.
authors.affiliation: Surgical ICU and Burns Center, University Hospital (CHUV), Lausanne, Switzerland. mette.berger@chuv.hospvd.ch
authors.forename: Mette M
authors.initials: MM
authors.lastname: Berger
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Revelly
authors.forename: Jean-Blaise
authors.initials: JB
authors.lastname: Wasserfallen
authors.forename: Aline
authors.initials: A
authors.lastname: Schmid
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bouvry
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Cayeux
authors.forename: Myriam
authors.initials: M
authors.lastname: Musset
authors.forename: Philippe
authors.initials: P
authors.lastname: Maravic
authors.forename: René L
authors.initials: RL
authors.lastname: Chiolero
mesh_terms: D002056:Burns / Q000628:therapy*; D003422:Critical Care / Q000592:standards; D016638:Critical Illness / Q000628:therapy; D002149:Energy Intake; D004750:Enteral Nutrition / Q000592:standards*; D005260:Female; D006751:Hospital Information Systems; D006801:Humans; D007362:Intensive Care Units / Q000592:standards; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements; D011446:Prospective Studies; D011787:Quality of Health Care; D016896:Treatment Outcome