title: Quality indicators for enteral and parenteral nutrition therapy: application in critically ill patients "at nutritional risk".
abstract: BACKGROUND
  Quality Indicators for Nutritional Therapy (QINT) allow a practical assessment of nutritional therapy (NT) quality.
  
  
  OBJECTIVE
  To apply and monitor QINT for critically ill patients at nutritional risk.
  
  
  METHODS
  Cross sectional study including critically ill patients > 18 years old, at nutritional risk, on exclusive enteral (ENT) or parenteral nutritional therapy (PNT) for > 72 hours. After three consecutive years, 9 QINT were applied and monitored. Statistical analysis was performed with SPSS version 17.0.
  
  
  RESULTS
  A total of 145 patients were included, 93 patients were receiving ENT, among then 65% were male and the mean age was 55.7 years (± 17.4); 52 patients were receiving PNT, 67% were male and the mean age was 58.1 years (± 17.4). All patients (ENT and PNT) were nutritionally screened at admission and their energy and protein needs were individually estimated. Only ENT was early initiated, more than 70% of the prescribed ENT volume was infused and there was a reduced withdrawal of enteral feeding tube. The frequency of diarrhea episodes and digestive fasting were not adequate in ENT patients. The proper supply of energy was contemplated only for PNT patients and there was an expressive rate of oral intake recovery in ENT patients.
  
  
  CONCLUSIONS
  After three years of research, the percentage of QINT adequacy varied between 55%-77% for ENT and 60%-80% for PNT. The results were only made possible by the efforts of a multidisciplinary team and the continuous re-evaluation of the procedures in order to maintain the nutritional assistance for patients at nutritional risk.
authors.affiliation: Intensive Care Unit. Professional Improvement Program. Hospital Nutrition. University Hospital. University of São Paulo. São Paulo, Brazil. ronaldonutrir@gmail.com.
authors.forename: Ronaldo Sousa
authors.initials: RS
authors.lastname: Oliveira Filho
authors.forename: Lia Mara Kauchi
authors.initials: LM
authors.lastname: Ribeiro
authors.forename: Lucia
authors.initials: L
authors.lastname: Caruso
authors.forename: Patricia Azevedo
authors.initials: PA
authors.lastname: Lima
authors.forename: Náglia Raquel Teixeira
authors.initials: NR
authors.lastname: Damasceno
authors.forename: Francisco
authors.initials: F
authors.lastname: García Soriano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000628:therapy*; D003430:Cross-Sectional Studies; D004750:Enteral Nutrition / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D010288:Parenteral Nutrition / Q000592:standards*; D019984:Quality Indicators, Health Care; D018570:Risk Assessment
keywords: Quality indicators.  Enteral nutrition.  Parenteral nutrition.  Critically ill patient.  Malnutrition.