Abstract

Author(s): Lesniovski dos Santos, Ana Paula1; Claudino, Larissa Marjorie1; Sbalqueiro Pistori, Mary Evelyn2; Mezzomo, Thais Regina2

Introduction: Quality indicators in nutritional therapy are evaluative instruments for the effectiveness of the therapeutics used, which aim to improve the performance of the procedures, as well as the improvement of nutritional and health care for the patients.

Objective: To apply quality indicators in enteral nutritional therapy (ENT) in a trauma ICU in the city of Curitiba, PR, Brazil and compare the results obtained between the years 2014 and 2015.

Methods: Retrospective descriptive observational study composed of data collected from nutritional monitoring charts of patients aged 18 years and over hospitalized in the years of 2014 and 2015 in a trauma ICU in Curitiba, PR, who received exclusive ENT. Sex, age, medical diagnosis, time to start infusion of the diet, time elapsed between the day of admission of the patient to the ICU on the first day that the patient received 50% of the proposed energetic goal, prescribed volume, volume infused and related complications gastrointestinal tract (GIT) were collected from the nutritional monitoring sheets. The quality indicators applied were: (1) frequency of fasting patients before the beginning of ENT; (2) rate of patients in ENT that reached 50% or more of the total energy value (TEV) within 7 days; (3) frequency of intercurrences related to the GIT; (4) frequency of episodes of diarrhea; (5) adequacy of the infused volume in relation to that prescribed in ENT patients.

Results: A total of 338 patients were evaluated, of which 194 were evaluated in 2014 and 144 in the year 2015, with a predominance of cranial trauma (82% in 2014 and 73% in 2015). The quality indicator (1) presented a 21% and 14% frequency of fasting patients before the onset of ENT in 2014 and 2015, respectively, the quality indicator (2) obtained 78 and 92% of ENT patients that reached 50% or more of TEV in up to 7 days in 2014 and 2015, respectively, the quality indicator (3) showed 34% and 33% of frequency of intercurrences related to GIT in the years 2014 and 2015, respectively. The quality indicator (4) showed 24 and 31% of the frequency of episodes of diarrhea in the years 2014 and 2015, respectively, and the quality indicator (5) showed 84 and 85% of adequacy of the volume infused in relation to that prescribed in patient in ENT in the years of 2014 and 2015, respectively

Conclusion: The quality indicators analyzed in this study that presented compliance were (2) and (5), corresponding to the rate of patients in ENT that reached 50% or more of the total energy value (TEV) within 7 days and the adequacy ofinfused volume in relation to that prescribed in ENT patients. The quality indicators (1), (3) and (4) did not reach the established goals, however, the comparison between the years 2014 and 2015 showed improvement in most quality indicators evaluated.