Critical analysis of factors affecting the efficiency of nutrition therapy teams.

BACKGROUND: Nutrition therapy (NT), defined as the provision of oral, enteral, or parenteral nutrition, should be considered a part of the holistic approach to patient care, while quality assessment of its practices is crucial. The present study aimed to identify variables capable of explaining the reason behind compliance of NTTs with the regulatory requirements. METHODS: A cross-sectional study focused on assessing the quality of nutritional therapy practices among NTTs who previously stated to be able to comply with requirements of the Brazilian law versus those who were not able to meet these demands. Hospitals were classified as A (teams that had previously reported to be able to meet the requirements) and B (those unable to comply with them). The study was approved by the ethics committees of all participant institutions. RESULTS: Twenty six hospitals met the inclusion criteria. The main hospital features, such as size, classification, service type, and percentage of hospitals providing NT were similar. Hospitals differed on the median number of patients undergoing NT per week: in group B (41.0; IR = 28.0-58.0) and group A (11.0; IR = 5.0-48.0) (p < 0.05), but there were no differences regarding personnel expertise. Both hospital groups had low quality control of the NT processes. CONCLUSION: Lack of quality assurance is responsible for the inadequate services in both type of institutions.

Implementing Quality Assessment Is Fundamental to Guarantee Optimal Nutrition Therapy.

INTRODUCTION: The implementation of quality assessment in nutrition therapy (NT) is an important strategy, with the potential to contribute to the reduction of malnutrition and improve the cost-effectiveness of NT. Studies on this subject are scarce in the world. Our objective was to evaluate the practice of NT in hospitals located in the third-most-developed state of Brazil. METHODS: A cross-sectional study, using data collected through interviews with members of the clinical staff/interdisciplinary NT team (NTT) and audits of clinical protocols and medical records, was carried out. Both non-probability and probability sampling techniques were used to select the hospitals. RESULTS: Thirty-three hospitals were included (10 public, 10 philanthropic, 9 private, and 4 university). Twenty-six institutions reported to have an NTT. There was no statistically significant difference in the existence and performance of the teams or in the presence of protocols and quality indicators between the types of hospitals. However, the inspection of 172 medical records showed that essential items for the nutrition care of the patient were not fully in agreement with the previous provided information, and this varied according to the type of hospital. CONCLUSION: The majority of hospitals had an NTT as well as protocols and quality indicators. However, patient records were not in accordance with the essential items to guarantee NT quality and safety, indicating a gap between theory and practice.