对全方位管营养的使用进行审计:我们是否正确使用它?
Anil Kumar1,2, Meghana Taggarsi3, Sajal Rai1
1Colorectal and General Surgery, Stepping Hill Hospital, Stockport NHS Foundation Trust, Stockport, GBR.
Cureus
|February 27, 2026
概括
本次审计显示,总体肠道营养 (TPN) 处方和营养师审查得到了改进,但强调了记录患者体重/BMI的下降. 多学科团队参与是最佳TPN交付的关键.
科学领域:
- 临床营养学 临床营养学
- 胃肠病学 胃肠病学
- 手术营养支持手术营养支持
背景情况:
- 对于患有非功能性或无法进入胃肠道 (GI) 的患者来说,全方位肠道营养 (TPN) 是至关重要的.
- 在可行的情况下,优先选择肠道营养;对TPN与肠道的风险/益处进行知情讨论至关重要.
- 对于适当的TPN使用,持续时间和监测,有指导方针.
研究的目的:
- 评估遵守TPN指导方针,包括紧急使用,持续时间和营养师参与.
- 将当前的TPN实践与国家标准 (NICE,NCEPOD) 和之前的审计进行比较.
- 确定在TPN服务提供和治理方面需要改进的领域.
主要方法:
- 接受TPN的成人整体外科患者的回顾性审计 (2019年8月至10月).
- 收集的数据是关于TPN的指示,食路线评估,BMI/体重,持续时间,处方,营养师审查和并发症.
- 与NICE (2017) 和NCEPOD (2010) 标准进行比较;与之前的三个审计周期 (2013-2016) 进行比较.
主要成果:
- 百分之百的证据表明TPN; 81.25%的人排除了替代养途径.
- 在审计周期中,在营养学家审查 (p=0.002) 和TPN处方准确性 (p<0.001) 中发现了显著的改善.
- 拒绝了BMI/体重的记录 (p=0.008);31.25%的医生在工作时间之外开始紧急TPN.
结论:
- 多学科团队的参与显著改善了TPN交付和患者护理.
- 在可用时优先考虑胃肠道营养仍然至关重要.
- 结果为医疗保健系统提供了洞察力,旨在加强TPN治理和质量保证.
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