PhilSPEN Online Journal of Parenteral and Enteral Nutrition

Back to Total Names Codes

(Article 76 | POJ_0070)

Submitted Abstracts

PENSA 2017 Congress

Submitted: August 11, 2017

Abstract ID = 40 | Classification: (6) - Parenteral nutrition

Title: Parenteral Nutrition: Beyond GUT feeling? Quality improvement initiative (QII) “Phase II”

Author(s): Pheiroijam Verenia Devi, Rajalakshmi.P, Vijayashanthi.C, Daphnee.D.K, Shankar B

Institution where study was conducted: Department of Dietetics, Apollo Hospitals, Greams Road, Chennai, India

Keywords: Parenteral Nutrition- Nutrition delivery- Quality Improvement Project

Background: A quality audit conducted to understand the clinical practice of parenteral nutrition (PN) (Phase-1, Feb 2010-2012) had helped us to introspect the quality issues and improve the nutritional delivery.

Objectives: This study aimed to evaluate the implementation of QII taken to enhance the delivery of PN

Methods: A prospective study was conducted in a tertiary care hospital from January’14 till March’17 which included patients who were on PN ≥3days (Phase-2) and compared with historic database (Phase-1). Patients’ demographics, baseline nutritional status, details of PN (route, product etc), nutritional delivery were analyzed using SPSS version 20.0.

Results: Out of 151 patients on PN, only 73 met the inclusion criteria in both critical and non-critical areas. Evident improvement in the PN prescription for the appropriate indicators like high output fistulas, gastrointestinal obstruction in Phase-2 was noted (p=0.006). Patient’s proportion and their nutritional status in the critical care unit (CCU) and wards were comparable in both the phases. Cessation of PN was quicker for well-nourished (5.60d) when compared with malnourished (7.37d) in Phase-2 (p=0.032). In Phase-2, the protein delivery in CCU was significantly higher, translating guidelines to practice (p=0.024). The nutritional delivery and proportion of patients achieving ≥75% of nutritional requirements in phase-2 was significantly higher compared to phase-1 (p<0.01)

Conclusion: Quality improvement initiatives like triggers to increase the rate of feeding, appropriate selection of the TPN bags and the interdisciplinary approach with daily monitoring by the nutrition support team lead to a remarkable improvement in the nutrition delivery resulting in better clinical nutrition practice.