High frequency of non-compliance with quality indicators during oral nutrition support in hospitalized patients

Abstract

Background & aims: Quality indicators are important tools in clinical practice for assessing and monitoring the quality of care in nutritional therapy. Application of these indicators can improve care and may help to decrease the high frequency of malnutrition and associated hospital costs. Therefore, the purpose of the present study was to estimate the frequency of oral nutritional supplements (ONS) use and to evaluate compliance with the four available quality indicators in oral nutritional therapy (QIONT) in a university hospital.

Methods: A prospective study was conducted from November 2017 to May 2018, using data from all patients with an ONS prescription aged 18 years or older admitted to the medical clinical or surgical clinical wards. Four indicators were investigated, as recommended by the International Life Science Institute.

Results: Of the 727 hospitalized patients in the included wards, 214 were on ONS. The frequency of ONS prescription was 29.4%. Of the 4 QIONT evaluated, none achieved the goals: frequency of subjective global assessment and reassessment nutritional (48.1% and 5.6%, respectively); frequency of non-compliance for the indication of ONS (73.36%); and fasting over 24 h during ONS (50%).

Conclusion: A high frequency of non-compliance (100% of QIONT) was observed in hospitalized patients on ONS in medical clinical and surgical clinical wards. These results will enable health professionals in the evaluated service to elaborate protocols to improve the evaluation and recording of the nutritional follow-up of hospitalized patients on ONS. This will help to improve the quality of nutritional care.

Keywords: Healthcare; Nutritional support; Nutritional therapy; Oral nutritional supplements; Quality indicators.