Modified minimal-contact COVID-19 workflow allows for safe, remote parenteral nutrition prescribing in non-critically ill patients.

Autor: Salazar E; Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore., Poh BY; Department of Pharmacy, Singapore General Hospital, Singapore., Cheang LY; Department of Pharmacy, Singapore General Hospital, Singapore., Tan LB; Department of Dietetics, Singapore General Hospital, Singapore., Yong PW; Department of Dietetics, Singapore General Hospital, Singapore., Cheah MCC; Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.
Jazyk: angličtina
Zdroj: JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2021 Aug; Vol. 45 (6), pp. 1364-1368. Date of Electronic Publication: 2021 Apr 20.
DOI: 10.1002/jpen.2104
Abstrakt: Background: In line with recent guidance from the American Society for Parenteral and Enteral Nutrition (ASPEN) and the European Society for Clinical Nutrition and Metabolism (ESPEN) to minimize healthcare team exposure by clustering care and relying on other providers or telehealth to collect relevant nutrition assessments, our nutrition support team has adopted a modified workflow using information technology to provide parenteral nutrition (PN) remotely in a safe and timely manner. We aim to compare our prescribing adequacy and PN-related complications before and during the coronavirus disease 2019 (COVID-19) outbreak using the modified workflow in non-critically ill patients.
Methods: This study reviewed a prospectively recruited cohort of adults receiving PN in the general wards or high-dependency units from December 5, 2019, to April 15, 2020. Demographic data, nutrition assessment, PN prescriptions, blood results, electronic notes, capillary blood glucose monitoring, and catheter-related bloodstream infection rates were reviewed for patients who received PN.
Results: We found that patients who started PN during COVID-19 were more malnourished with lower body mass index and higher proportion of Subjective Global Assessment B/C scores (52 [92.9%] vs 36 [73.5%], P < .005). The proportion of patients who achieved target energy amounts within 5 days was similar in both groups. Protein prescription was >1 g/kg/day in both groups, though there was a trend of higher protein prescription during COVID-19. Complications were similar in both groups.
Conclusion: Our study demonstrates that minimal contact with effective multidisciplinary communication using the modified workflow can allow for safe and timely PN administration.
(© 2021 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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