Meal Supervision During Medical Hospitalization for Eating Disorders

2016 ◽  
Vol 26 (4) ◽  
pp. 525-537 ◽  
Author(s):  
Meredith Kells ◽  
Pamela Schubert-Bob ◽  
Katharine Nagle ◽  
Louise Hitchko ◽  
Kathleen O’Neil ◽  
...  
Keyword(s):  
Health Care ◽  
Eating Disorders ◽  
Weight Gain ◽  
Length Of Stay ◽  
Chart Review ◽  
Vital Signs ◽  
Restrictive Eating ◽  
Gain Length ◽  
Care Costs ◽  
Supportive Intervention

The focus of medical hospitalization for restrictive eating disorders is weight gain; however, no guidelines exist on how to achieve successful and safe weight gain. Meal supervision may be a supportive intervention to aid in meal completion and weight gain. The aim of this study was to examine the effect of standardized meal supervision on weight gain, length of stay, vital signs, electrolytes, and use of liquid caloric supplementation in hospitalized adolescents and young adults with restrictive eating disorders. A chart review compared patients who received meal supervision from admission through discharge to an earlier cohort who received meal supervision as needed. There were no differences in weight, electrolytes, or vital signs between the two cohorts. Length of stay for those who received meal supervision from admission was 3 days shorter than earlier cohort. Nursing supervised meals beginning at admission may shorten length of stay and decrease health care costs.

scholarly journals Higher Caloric Refeeding Is Safe in Hospitalised Adolescent Patients with Restrictive Eating Disorders

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Elizabeth K. Parker ◽  
Sahrish S. Faruquie ◽  
Gail Anderson ◽  
Linette Gomes ◽  
Andrew Kennedy ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Weight Gain ◽  
Statistical Significance ◽  
Caloric Intake ◽  
Tube Feeding ◽  
Retrospective Chart Review ◽  
Refeeding Syndrome ◽  
Restrictive Eating ◽  
Weight Restoration ◽  
The Mean

Introduction. This study examines weight gain and assesses complications associated with refeeding hospitalised adolescents with restrictive eating disorders (EDs) prescribed initial calories above current recommendations.Methods. Patients admitted to an adolescent ED structured “rapid refeeding” program for >48 hours and receiving ≥2400 kcal/day were included in a 3-year retrospective chart review.Results. The mean (SD) age of the 162 adolescents was 16.7 years (0.9), admission % median BMI was 80.1% (10.2), and discharge % median BMI was 93.1% (7.0). The mean (SD) starting caloric intake was 2611.7 kcal/day (261.5) equating to 58.4 kcal/kg (10.2). Most patients (92.6%) were treated with nasogastric tube feeding. The mean (SD) length of stay was 3.6 weeks (1.9), and average weekly weight gain was 2.1 kg (0.8). No patients developed cardiac signs of RFS or delirium; complications included 4% peripheral oedema, 1% hypophosphatemia (<0.75 mmol/L), 7% hypomagnesaemia (<0.70 mmol/L), and 2% hypokalaemia (<3.2 mmol/L). Caloric prescription on admission was associated with developing oedema (95% CI 1.001 to 1.047;p=0.039). No statistical significance was found between electrolytes and calories provided during refeeding.Conclusion. A rapid refeeding protocol with the inclusion of phosphate supplementation can safely achieve rapid weight restoration without increased complications associated with refeeding syndrome.

Eating Disorders: Identification and Management in General Medical and Psychiatric Settings

2021 ◽  
pp. 107839032199971
Author(s):  
Rebecca A. Owens ◽  
Evelyn Attia ◽  
Joyce J. Fitzpatrick ◽  
Kathryn Phillips ◽  
Stephanie Nolan
Keyword(s):  
Health Care ◽  
Eating Disorders ◽  
Assessment Tool ◽  
Psychiatric Morbidity ◽  
Clinical Settings ◽  
Life Saving ◽  
Treatment Plans ◽  
Receive Treatment ◽  
Health Features ◽  
Care Costs

OBJECTIVE Eating disorders (EDs) are serious, complex illnesses with both behavioral and physical health features. EDs have high rates of medical and psychiatric morbidity, and a 6% mortality rate, the highest of any mental illness. Early detection of EDs offers the best opportunity for recovery; yet, estimates are that as few as one in 10 individuals with an ED receive treatment. The purpose of this article is to provide an ED identification and management overview for inpatient nurse clinicians in general psychiatric and medical settings, helping to facilitate timely recognition and care. METHOD An overview of ED diagnostic criteria and two evidence-based ED tools are introduced for consideration. RESULTS Opportunities to identify and help manage an ED are numerous. Most individuals with an ED make several health care visits in either medical or psychiatric settings without ever being screened for an ED. General ED screening and assessment tool familiarization can facilitate a treatment trajectory for these patients, improve overall quality of life, and may potentially result in a life-saving intervention for this often-deadly cluster of medical and psychiatric disorders. CONCLUSION Screening and assessment in general clinical settings, identifying patients with undiagnosed EDs, beginning basic treatment plans, and referrals for appropriate follow-up care, have the potential to reduce ED recidivism and related health care costs. Simultaneously, and most important, long-term outcomes for patients with EDs may improve.

Opioid-Related Adverse Events: Incidence and Impact in Patients Undergoing Cardiac Surgery

2019 ◽  
Vol 24 (3) ◽  
pp. 219-226 ◽  
Author(s):  
Keith B. Allen ◽  
Ethan Y. Brovman ◽  
Adnan K. Chhatriwalla ◽  
Katherine J. Greco ◽  
Nikhilesh Rao ◽  
...  
Keyword(s):  
Health Care ◽  
Cardiac Surgery ◽  
Pain Management ◽  
Length Of Stay ◽  
Health Care Costs ◽  
Adverse Drug Events ◽  
Management Strategies ◽  
Coronary Bypass ◽  
Administrative Claims ◽  
Care Costs

Purpose. Opioid-related adverse drug events (ORADEs) increase patient length of stay (LOS) and health care costs. However, ORADE rates may be underreported. This study attempts to understand the degree to which ORADEs are underreported in Medicare patients undergoing cardiac surgery. Materials and Methods. The Center for Medicare and Medicaid Services administrative claims database was used to identify ORADEs in 110 158 Medicare beneficiaries who underwent cardiac valve (n = 50 525) or coronary bypass (n = 59 633) surgery between April 2016 and March 2017. The International Classification of Disease (ICD)-10 codes specifically linked to ORADEs were used to identify an actual ORADE rate, while additional ICD codes, clinically associated with butas not specific to adverse drug events were analyzed as potential ORADEs. Length of stay (LOS) and hospital daily revenue were analyzed among patients with or without a potential ORADE. Results. Among patients undergoing valve or bypass surgery, the documented ORADE rate was 0.7% (743/110 158). However, potential ORADEs may have occurred in up to 32.4% (35 658/110 158) of patients. In patients with a potential ORADE, mean LOS was longer (11.4 vs 8.2 days; P < .0001) and mean Medicare revenue/day was lower ($4016 vs $4412; P < .0001). The mean net difference in revenue/day between patients with and without an ORADE varied between $231 and $1145, depending on the Diagnosis-Related Group analyzed. Conclusions. ORADEs are likely underreported following cardiac surgery. ORADEs can be associated with increased LOS and decreased hospital revenue. Understanding the incidence and economic impact of ORADEs may expedite changes to postoperative pain management. Adopting multimodal pain management strategies that reduce exposure to opioids may improve outcomes by reducing complications, side effects, and health care costs.

PP142-SUN: Home Enteral Nutrition (HEN) Helps to Reduce Complications, Length of Stay and Health-Care Costs in Adults

2014 ◽  
Vol 33 ◽  
pp. S73
Author(s):  
S. Klek ◽  
A. Hermanowicz ◽  
G. Dziwiszek ◽  
K. Matysiak ◽  
K. Szczepanek ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Enteral Nutrition ◽  
Health Care Costs ◽  
Home Enteral Nutrition ◽  
Care Costs

scholarly journals The effect of surgical site infection on the length of stay and health care costs

2011 ◽  
Vol 21 (1) ◽  
pp. 44-60 ◽  
Author(s):  
Jin-Hee Chang ◽  
Kyoung-Hoon Kim ◽  
Soon-Man Kwon ◽  
Seon-A Yeom ◽  
Choon-Seon Park
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Surgical Site Infection ◽  
Health Care Costs ◽  
Site Infection ◽  
Care Costs

The health service use and cost of eating disorders

2005 ◽  
Vol 35 (11) ◽  
pp. 1543-1551 ◽  
Author(s):  
JUDIT SIMON ◽  
ULRIKE SCHMIDT ◽  
STEPHEN PILLING
Keyword(s):  
Health Care ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Resource Use ◽  
Service Use ◽  
Health Care Cost ◽  
Health Service Use ◽  
The Uk ◽  
Care Costs ◽  
Cost Of Illness Studies

Background. The economic burden and health service use of eating disorders have received little attention, although such data are necessary to estimate the implications of any changes in clinical practice for patient care and health care resource requirements. This systematic review reports the current international evidence on the resource use and cost of eating disorders.Method. Relevant literature (1980–2002) was identified from searches of electronic databases and expert contacts.Results. Two cost-of-illness studies from the UK and Germany, one burden-of-disease study from Australia and 14 other publications with relevant data from the UK, USA, Austria, Denmark and The Netherlands could be identified. In the UK, the health care cost of anorexia nervosa was estimated to be £4·2 million in 1990. In Germany, the health care cost was €65 million for anorexia nervosa and €10 million for bulimia nervosa during 1998. The Australian study reported the health care costs of eating disorders to be Aus$22 million for year 1993/1994. Other costing studies focused mostly on in-patient care reporting highly variable estimates. There is a dearth of research on non-health care costs.Conclusions. The limited available evidence reflects a general under-detection and under-treatment of eating disorders. Although both cost-of-illness studies may significantly underestimate the costs of eating disorders because of important omitted cost items, other evidence suggests that the economic burden is likely to be substantial. Comprehensive data on the resource use of patients with eating disorders are urgently needed for better estimations, and to be able to determine cost-effective treatment options.

PP135-SUN: Home Enteral Tube Feeding Reduces Complications, Length of Stay and Health-Care Costs in Children

2014 ◽  
Vol 33 ◽  
pp. S70
Author(s):  
S. Klek ◽  
A. Hermanowicz ◽  
G. Dziwiszek ◽  
K. Szczepanek ◽  
P. Szybinski ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Health Care Costs ◽  
Tube Feeding ◽  
Enteral Tube Feeding ◽  
Care Costs
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