A framework to support quality of care for patients with chronic intestinal failure requiring home parenteral nutrition.

Autor: Osland EJ; Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.; School of Human Movements and Nutrition Science, University of Queensland, Brisbane, Queensland, Australia., McGrath KH; Department of Gastroenterology and Nutrition, Birmingham Children's Hospital, Birmingham, UK.; Intestinal Failure and Clinical Nutrition Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia., Ali A; Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia., Carey S; Department of Nutrition and Dietetics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.; School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia., Daniells S; Department of Nutrition and Dietetics, Prince of Wales Hospital, Randwick, New South Wales, Australia., Angstmann K; Division Surgery, Royal North Shore Hospital, Saint Leonards, New South Wales, Australia., Bines J; Intestinal Failure and Clinical Nutrition Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.; Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Melbourne, Victoria, Australia., Asrani V; Department of Nutrition and Dietetics, Auckland City Hospital, Auckland, New Zealand.; Department of Surgery, School of Medicine, University of Auckland, Auckland, New Zealand., Watson C; Department of Nutrition and Dietetics, Monash Children's Hospital, Melbourne, Victoria, Australia., Jones L; Intestinal Failure Service, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia., De Cruz P; Department of Gastroenterology, Austin Health, Melbourne, Victoria, Australia.; Department of Medicine, Austin Academic Centre, University of Melbourne, Heidelberg, Victoria, Australia.
Jazyk: angličtina
Zdroj: Journal of gastroenterology and hepatology [J Gastroenterol Hepatol] 2020 Apr; Vol. 35 (4), pp. 567-576. Date of Electronic Publication: 2019 Oct 30.
DOI: 10.1111/jgh.14841
Abstrakt: Background and Aim: Chronic intestinal failure requiring home parenteral nutrition (HPN) is a disabling condition that is best facilitated by a multidisciplinary approach to care. Variation in care has been identified as a key barrier to achieving quality of care for patients on HPN and requires appropriate strategies to help standardize management.
Method: The Australasian Society for Parenteral and Enteral Nutrition (AuSPEN) assembled a multidisciplinary working group of 15 clinicians to develop a quality framework to assist with the standardization of HPN care in Australia. Obstacles to quality care specific to Australia were identified by consensus. Drafts of the framework documents were based on the available literature and refined by two Delphi rounds with the clinician work group, followed by a further two involving HPN consumers. The Oxford Centre for Evidence-Based Medicine Levels of Evidence was used to assess the strength of evidence underpinning each concept within the framework documents.
Results: Quality indicators, standards of care, and position statements have been developed to progress the delivery of quality care to HPN patients.
Conclusion: The quality framework proposed by AuSPEN is intended to provide a practical structure for clinical and organizational aspects of HPN service delivery to reduce variation in care and improve quality of care and represents the initial step towards development of a national model of care for HPN patients in Australia. While developed for implementation in Australia, the evidence-based framework also has relevance to the international HPN community.
(© 2019 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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