scholarly journals Efficacy and Efficiency of Nutritional Support Teams

2019 ◽  
Vol 8 (9) ◽  
pp. 1281 ◽  
Author(s):  
Reber ◽  
Strahm ◽  
Bally ◽  
Schuetz ◽  
Stanga
Keyword(s):  
Nutritional Status ◽  
Hospital Stay ◽  
Nutritional Support ◽  
Care Plan ◽  
Current Evidence ◽  
Nutritional Management ◽  
Complication Rates ◽  
Nutritional Care ◽  
Support Teams

Malnutrition is frequent in patients during a hospital admission and may further worsen during the hospital stay without appropriate nutritional support. Malnutrition causes greater complication rates, morbidity, and mortality rates, which increases the length of hospital stay and prolongs rehabilitation. Early recognition of individual nutritional risk and timely initiation of a tailored nutritional therapy are crucial. Recent evidence from large-scale trials suggests that efficient nutritional management not only improves the nutritional status, but also prevents negative clinical outcomes and increases patients’ quality of life. Multifaceted clinical knowledge is required to ensure optimal nutritional support, according to a patient’s individual situation and to avoid potential complications. Furthermore, clear definition of responsibilities and structuring of patient, and work processes are indispensable. Interdisciplinary and multiprofessional nutritional support teams have been built up to ensure and improve the quality and safety of nutritional treatments. These teams continuously check and optimize the quality of procedures in the core areas of nutritional management by implementing nutritional screening processes using a validated tool, nutritional status assessment, an adequate nutritional care plan development, prompt and targeted nutritional treatment delivery, and provision of accurate monitoring to oversee all aspects of care, from catering to artificial nutrition. The foundation of any nutritional care plan is the identification of patients at risk. The aim of this narrative review is to provide an overview about composition, tasks, and challenges of nutritional support teams, and to discuss the current evidence regarding their efficiency and efficacy in terms of clinical outcome and cost effectiveness.

New coronavirus infection COVID-19: how do we feed the sick?

2021 ◽  
Author(s):  
И.Н. Пасечник ◽  
А.А. Щучко ◽  
В.В. Сазонов ◽  
Т.Б. Иванова
Keyword(s):  
Nutritional Status ◽  
European Society ◽  
Nutritional Support ◽  
Clinical Nutrition ◽  
Comprehensive Treatment ◽  
Rehabilitation Programs ◽  
Number Of Patients ◽  
Coronavirus Infection ◽  
The Uk

Повышение качества оказания помощи больным новой коронавирусной инфекцией COVID-19 возможно только на основе мультидисциплинарного подхода. Оценка пищевого статуса и при необходимости его коррекция являются важной составляющей комплексных программ лечения и реабилитации таких больных. Значительное число пациентов с COVID-19 составляют люди пожилого и старческого возраста, у которых уже есть признаки нутритивной недостаточности. Нарушения питания и сопутствующая им саркопения – факторы риска неблагоприятного течения COVID-19. Прогрессирование саркопении при COVID-19 объясняют возникновением вирусного миозита, миопатией, спровоцированной цитокинами, и иммобилизацией. Уменьшение мышечной массы ассоциировано с плохим прогнозом заболевания и снижением качества жизни. Коррекция нарушений пищевого статуса больных COVID-19 должна проводиться на всех этапах лечения. Важность проблемы нутритивной поддержки отражена во множестве публикаций, посвященных лечению больных COVID-19. Необходимо заметить, что Европейское общество клинического питания и метаболизма (European Society for Clinical Nutrition and Metabolism, ESPEN) в кратчайшие сроки выпустило рекомендации по нутритивной поддержке больных новой коронавирусной инфекцией, что лишний раз подчеркивает актуальность проблемы. Это стало логичным продолжением рекомендаций по коррекции пищевого статуса больных, находящихся на лечении в отделении реанимации и интенсивной терапии. Аналогичные клинические рекомендации были разработаны в Великобритании, Бразилии и целом ряде других стран. Использование препаратов для перорального дополнительного питания в большинстве случаев позволяет обеспечить потребности пациентов в необходимых нутриентах, уменьшить выраженность саркопении и повысить эффективность реабилитационных мероприятий. Improving the quality of care for patients with the new coronavirus infection COVID-19 is possible only on the basis of a multidisciplinary approach. Evaluation of nutritional status and, if necessary, its correction are an important component of comprehensive treatment and rehabilitation programs for such patients. A significant number of patients with COVID-19 are elderly and senile people who already have signs of nutritional deficiency. Eating disorders and accompanying sarcopenia are risk factors for the adverse course of COVID-19. The progression of sarcopenia in COVID-19 is explained by the occurrence of viral myositis, myopathy provoked by cytokines, and immobilization. Decreased muscle mass is associated with poor disease prognosis and reduced quality of life. Correction of nutritional disorders in patients with COVID-19 should be carried out at all stages of treatment. The importance of the problem of nutritional support is reflected in many publications devoted to the treatment of patients with COVID-19. It should be noted that the European Society for Clinical Nutrition and Metabolism (ESPEN) promptly issued recommendations on nutritional support for patients with new coronavirus infection, which once again emphasizes the urgency of the problem. This was a logical continuation of the recommendations for correcting the nutritional status of patients undergoing treatment in the intensive care unit. Similar clinical guidelines have been developed in the UK, Brazil and a number of other countries. The use of drugs for oral supplementary nutrition in most cases allows to meet the needs of patients for the necessary nutrients, to reduce the severity of sarcopenia and to increase the effectiveness of rehabilitation measures.

scholarly journals Nutritional Risk Screening and Assessment

2019 ◽  
Vol 8 (7) ◽  
pp. 1065 ◽  
Author(s):  
Emilie Reber ◽  
Filomena Gomes ◽  
Maria F. Vasiloglou ◽  
Philipp Schuetz ◽  
Zeno Stanga
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
Nutritional Support ◽  
Nutritional Risk ◽  
Nutritional Management ◽  
Risk Screening ◽  
Care Plans ◽  
Patients At Risk ◽  
Nutritional Risk Screening

Malnutrition is an independent risk factor that negatively influences patients’ clinical outcomes, quality of life, body function, and autonomy. Early identification of patients at risk of malnutrition or who are malnourished is crucial in order to start a timely and adequate nutritional support. Nutritional risk screening, a simple and rapid first-line tool to detect patients at risk of malnutrition, should be performed systematically in patients at hospital admission. Patients with nutritional risk should subsequently undergo a more detailed nutritional assessment to identify and quantify specific nutritional problems. Such an assessment includes subjective and objective parameters such as medical history, current and past dietary intake (including energy and protein balance), physical examination and anthropometric measurements, functional and mental assessment, quality of life, medications, and laboratory values. Nutritional care plans should be developed in a multidisciplinary approach, and implemented to maintain and improve patients’ nutritional condition. Standardized nutritional management including systematic risk screening and assessment may also contribute to reduced healthcare costs. Adequate and timely implementation of nutritional support has been linked with favorable outcomes such as a decrease in length of hospital stay, reduced mortality, and reductions in the rate of severe complications, as well as improvements in quality of life and functional status. The aim of this review article is to provide a comprehensive overview of nutritional screening and assessment methods that can contribute to an effective and well-structured nutritional management (process cascade) of hospitalized patients.

Evaluation of the nutritional status in children with acute lymphoblastic leukemia and its effect on the outcome of induction in a developing country.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e22004-e22004
Author(s):  
Arifa Khalid ◽  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Nutritional Status ◽  
Hospital Stay ◽  
Nutritional Support ◽  
Lymphoblastic Leukemia ◽  
P Value ◽  
Z Score ◽  
Female Ratio ◽  
Duration Of Hospital Stay ◽  
End Of Treatment

e22004 Background: Acute Lymphoblastic Leukemia (ALL) is the most frequently occurring cancer among the children and adolescents. Cure rate is improved up to 90% with early diagnosis and better supportive care. Under nutrition among pediatric acute leukemia patients is more in developing countries 60% as compared to 10% in developed countries. The poor nutritional status is found to be associated with poor outcome. Therefore, optimum nutritional support can play a vital role in the outcome of induction. Methods: The population of research was newly diagnosed patients of ALL, reported from June 2016 to January 2017, in the Pediatric Hematology & Oncology Department of Children’s Hospital, Lahore. A sample of 151 patients of Acute Lymphoblastic Leukemia was analyzed prospectively. The study subjects were stratified into undernourished & well nourished based on the Z-score for weight for age.The data was collected irrespective of any discrimination based on demographic factors. and the following characters were recorded in both the groups: Mid treatment & end of treatment bone marrow response, culture proved infection, duration of hospital stay & outcome. Results: Among the 151 patients of ALL 80.1 % (n = 121) were Pre-B and 19.8% (n = 30) were Pre-T .Male to female ratio was 1.5:1. Malnutrition was established in 98 (64.9%) patients on the bases of Z-score. The undernourished group had significantly increased rate of culture proven sepsis (11% vs. 2%) respectively and required longer duration of hospital stay (p < 0.001).Rapid early response was observed in 21.8% malnourished and 32.8% well-nourished patients. End of treatment complete response was recorded in 63% vs. 69.1% respectively with significant p value. Expiry was observed in 9.1% malnourished patients. Conclusions: On the basis of this study it is concluded that the nutritional status at the initial presentation had a significant impact on the induction outcome. The undernourished patients of ALL are more prone to infections, requiring longer duration of hospital stay. Therefore, optimum nutritional support to such patients can help to decrease the chances of infections & ultimately improve the outcome.

scholarly journals Usefulness of Smartphone Applications for Improving Nutritional Status of Pancreatic Cancer Patients: A Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Jiyoung Keum ◽  
Moon Jae Chung ◽  
Youngin Kim ◽  
Hyunyoung Ko ◽  
Min Je Sung ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nutritional Status ◽  
Nutritional Support ◽  
Mobile App ◽  
Ductal Adenocarcinoma ◽  
User Group ◽  
European Organization ◽  
Skeletal Muscle Index ◽  
Quality Of Life Scale

BACKGROUND Approximately 80% of pancreatic ductal adenocarcinoma (PDAC) patients suffer from anorexia, weight loss, asthenia, and a poor prognosis. Moreover, in this context, nutritional management of PDAC patients during the chemotherapy is a key factor in prognosis than any other cancer. PDAC is the type cancer that requires the most nutritional support. Mobile applications (apps) have the potential to provide easily accessible nutritional support for patients with PDAC. OBJECTIVE We aimed to evaluate the efficacy of a mobile app-based program, Noom, in patients receiving chemotherapy for PDAC METHODS We prospectively enrolled patients who were newly diagnosed with unresectable PDAC and randomly assigned them into the Noom user group (n=20) and the non-Noom user group (n=20). The in-app interventions with behavior and nutritional education lasted for 12 weeks. Dietitians monitored these data and provided nutritional feedback. Patients also completed paper questionnaires at baseline and after 4, 8, and 12 weeks. RESULTS Above average Noom users showed a significant improvement in nutritional status according to the Patient-Generated Subjective Global Assessment (P=.03). Noom users showed a statistically significant improvement on the Global Health Status and Quality of Life scale compared to non-Noom users based on the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (P=.02). Particularly, skeletal muscle index was significantly higher in above average Noom users compared to non-Noom users during the study period (+5.58% versus -13.96%, P=.04). CONCLUSIONS This pilot study demonstrated that a mobile app-based approach was beneficial for nutritional and psychological support for patients receiving chemotherapy for PDAC. CLINICALTRIAL ClinicalTrials.gov NCT04109495

scholarly journals Role of nutritional care and general guidance for patients with advanced or metastatic gastric cancer

2021 ◽  
Author(s):  
Takuro Mizukami ◽  
Yongzhe Piao
Keyword(s):  
Gastric Cancer ◽  
Nutritional Status ◽  
Care Management ◽  
Metastatic Gastric Cancer ◽  
Nutritional Care ◽  
Medical Specialists ◽  
Clinical Meaning ◽  
General Guidance

Patients with advanced or metastatic gastric cancer often suffer from malnutrition, which can have an impact on quality of life, increase the toxicity of chemotherapy and reduce overall survival. Options available to the clinician to manage a patient’s nutritional status include screening and assessment of malnutrition at diagnosis, monitoring during the ‘cancer journey’, early detection of precachexia and the ongoing use of a multidisciplinary team (oncologists, other medical specialists and nutritionists). Because malnutrition is frequently overlooked and under treated in patients with advanced or metastatic gastric cancer, this narrative review focuses on the clinical meaning of nutritional status in gastric cancer and provides general guidance regarding nutritional care management for patients with advanced or metastatic gastric cancer.

scholarly journals The state of cachexia in immunocompromised patients. View from the nurse. Review of own experience

2019 ◽  
Vol 6 (1) ◽  
pp. 70-75
Author(s):  
N. P. Leshchuk ◽  
O. V. Pimenova ◽  
M. S. Shamsutdinova ◽  
A. B. Abrosimov ◽  
L. N. Shelikhov
Keyword(s):  
Nutritional Status ◽  
Nutritional Support ◽  
Multidisciplinary Approach ◽  
Immunocompromised Patients ◽  
Age Group ◽  
Hematopoietic Stem ◽  
Results Of Treatment ◽  
Direct Training ◽  
Conditioning Therapy

Introduction. Today, the problem of nutritional deficiency (ND) in children undergoing conditioning therapy and after hematopoietic stem cell transplantation (HSCT) remains relevant. The main goal for success is the interaction of doctors of various specialties, nurses and clinical psychologists. In the treatment process, a nurse occupies one of the key places; the process of passing nutritional support and returning to normal nutritional status depend on her knowledge, qualifications and skills. Materials and methods. Thirty-eight immunocompromised patients were included in the study (patients of the HSCT unit who received conditioning therapy). According to nutritional status: in 18 patients, ND was noted on day –1 before HSCT, in 10 patients, ND was noted on + 5–7th days after HSCT, and in 10 children, normal nutritional status remained. In terms of the incidence of adverse complications of chemotherapy (CT): nausea, vomiting, mucositis, and diarrhea were noted mainly in the age group up to 3 years; the presence of pain is more pronounced in children from 3 to 10 years; A change in the taste of the food intake was more present in the age group from 10 to 18 years. Results. The majority of patients (75 %) who received conditioning therapy and after HSCT had ND. Between the day +1 and + 7th day, mixed nutritional support was assigned after the HSCT. With the development of complications after chemotherapy, recommendations and measures were developed to reduce the effects of the treatment. Findings. Due to screening for ND and a multidisciplinary approach, nutritional support is a necessary component when conducting various types of antitumor treatment, which in turn improves the results of treatment and the quality of life of patients. On the part of the nursing staff, recommendations on the management of patients with ND and direct training of their legal representatives were actively applied. 

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