Selection of top 10 quality indicators for nutrition therapy.
BACKGROUND
The identification of useful quality indicators for nutrition therapy (QINTs) is of great interest and a challenge. This study attempted to identify the 10 QINTs that best suit the practice of quality control in nutrition therapy (NT) by evaluating the opinion of experts in NT with the use of psychometric techniques and statistical tools.


METHODS
Thirty-six QINTs available for clinical application in Brazil were assessed in 2 distinct phases. In phase 1, 26 nutrition experts ranked QINTs by scoring 4 attributes (utility, simplicity, objectivity, low cost) to assess each QINT on a 5-point Likert scale. The top 10 QINTs were identified from the 10 best scores obtained, and the reliability of expert opinion for each indicator was assessed by Cronbach's α. In phase 2, experts provided feedback regarding the selected top 10 QINTs by answering 2 closed questions.


RESULTS
The top 10 QINTs, in descending order, are the frequency of nutrition screening of hospitalized patients, diarrhea, involuntary withdrawal of enteral feeding tubes, feeding tube obstruction, fasting longer than 24 hours, glycemic dysfunction, estimated energy expenditure and protein needs, central venous catheter infection, compliance of NT indication, and frequency of application of subjective global assessment. Opinions were consistent among the interviewed experts. During feedback, 96% of experts were satisfied with the top 10 QINTs, and 100% had considered them in accordance with their previous opinion.


CONCLUSIONS
The top 10 QINTs were identified according to their usefulness in clinical practice by obtaining adequate agreement and representativeness of opinion of nutrition experts.
University of São Paulo, School of Medicine, Department of Gastroenterology, São Paulo, Brazil. nutricristiane@me.com
Cristiane Comeron Gimenez
CC
Verotti
Raquel Susana Matos de Miranda
RS
Torrinhas
Ivan
I
Cecconello
Dan Linetzky
DL
Waitzberg
D001291:Attitude of Health Personnel; D001938:Brazil; D004750:Enteral Nutrition / Q000379:methods / Q000592:standards*; D006801:Humans; D007407:Interviews as Topic; D017063:Outcome Assessment, Health Care; D010549:Personal Satisfaction; D011786:Quality Control; D019984:Quality Indicators, Health Care