title: Enteral nutritional therapy: application of quality indicators.
abstract: OBJECTIVE
  Monitor the adequacy of enteral nutritional therapy at the intensive care unit aiming to improve the quality of nutritional assistance.
  
  
  METHODS
  Prospective and observational study developed at the adult intensive care unit from 2005 to 2008. Patients over 18 years of age with exclusive enteral nutritional therapy for over 72h participated in the sample. The average values and the percentile adequacy of energy and proteins calculated, prescribed and administered in each year were analyzed. The factors responsible for the non-conformity of the administration planned were classified into intensive care unit extrinsic or intrinsic causes. The quality indicators proposed by the ILSI Brazil were applied, and expressed into percentile goals. In the statistic analyses, confidence interval and the t Student e Mann-Whitney (p<0.05) tests were used, according to the Epi Info program.
  
  
  RESULTS
  One hundred and sixteen patients were followed up. There were statically difference in values of energy and protein administered in 2005 and in 2006, when compared to those in 2008. The adequacy calculated/prescribed remained close to 100% in all the surveys and the adequacy administered/prescribed increased from 74% in 2005, to 89% in 2008. An increase in interruptions of enteral nutritional therapy for external factors and the decrease in interruptions for intensive care unit internal factors were verified. The quality indicators equally reflect the evolution of the patient care.
  
  
  CONCLUSIONS
  In the four yearly surveys, a progressive enhancement of nutritional support was verified. Quality indicators allow nutritional care evolution monitoring, the comparison to other services data, and are a new perspective for enteral nutritional therapy assessment.
authors.affiliation: Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Flávia De Conti
authors.initials: Fde C
authors.lastname: Cartolano
authors.affiliation: Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Lúcia
authors.initials: L
authors.lastname: Caruso
authors.affiliation: Unidade da Terapia Intensiva Adulto, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Francisco Garcia
authors.initials: FG
authors.lastname: Soriano