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Abstract

The monitoring of the quality of patient care in today's health care environment may be best accomplished through collaborative continuous quality improvement (CQI) programs using the efforts of physicians, nurses, dietitians, and other health care professionals. The CQI Committee of the Pediatric Intensive Care Unit (PICU), a 10-bed combined medical and surgical unit, developed a collaborative CQI audit to monitor whether critically ill PICU patients should receive nutrition therapy (oral, enteral, or parenteral) in a timely manner. Timely nutrition support was defined as initiation of nutrition therapy within 72 hours of admission for previously well-nourished patients (category A) or within 48 hours of admission for patients with a history of chronic illness, malnutrition, or trauma (category B). Whether pediatric nutrition support team consultations on category B patients were completed within 72 hours of admission to the PICU also was monitored. An evaluation goal of 80% was set to meet the indicator criteria.

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References

1. Geibig CB , Mirtallo JM , Owens, J . Quality assurance for a nutritional support service. Nutr Clin Pract 1991;6:147–50.

2. Dougherty D , Bankhead R , Kushner R , et al . Nutrition care given new importance in JCAHO standards. Nutr Clin Pract: [Supplement—Health Care in Transition] 1995;10:57S–62S.

3. Flanel DF , Fairchild, MM . Continuous quality improvement in inpatient clinical nutrition services. J Am Diet Assoc 1995;95:65–75.

4. Minard G , Kudsk, KA . Is early feeding beneficial? How early is early? New Horizons 1994;2:156–62.

5. Chwals, WJ . Overfeeding the critically ill child: fact or fantasy? New Horizons 1994;2:147–55.

6. Trocki O , Michelini JA , Robbins ST , et al . Evaluation of early enteral feeding in children 3 years old with smaller burns (8–25 percent TBSA). Burns 1995;21:17–22.

7. Kudsk KA , Stone JM , Carpenter G , et al . Enteral and parenteral feeding influences mortality after hemoglobin–E. coli peritonitis in normal rats. J Trauma 1983;23:605–9.

8. Moore FA , Moore EE , Jones TN , et al . TEN versus total parenteral nutrition (TPN) following major abdominal traumA—reduced septic morbidity. J Trauma 1989;29:916–23.

9. A.S.P.E.N. Board of Directors . Standards for nutrition support of hospitalized pediatric patients. Nutr Clin Pract 1989;4:33–7.

10.

10. A.S.P.E.N. Board of Directors . Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. JPEN 1993;17:515–25.

11.

11. Srp F , Ayello EA , Andujar E , et al . Quality of care concepts and nutrition support. Nutr Clin Pract 1991;6:131–41.

12.

12. Zaloga, G . Bedside method for placing small bowel feeding tubes in critically ill patients. A prospective study. Chest 1991;100:1643–6.

13.

13. Mueller, C . Early enteral nutrition support: rationale and technique. Support Line 1993;15:1–5.

14.

14. Young B , Ott L , Haack D , et al . Effect of TPN upon intracranial pressure in severe head injury. J Neurosurg 1987;67:76–80.

15.

15. Ott L , Young, B . Nutrition in the neurologically injured patient. Nutr Clin Pract 1990;5:68–78.

16.

16. Hohenbrink K , Nicol, JJ . Pediatrics. In: Gottschlich MM , Matarese LE , Shronts EP , eds, Nutrition Support Dietetics Core Curriculum. Silver Spring, MD: American Society for Parenteral and Enteral Nutrition, 1993;163–92.

17.

17. Abad-Sinden A. Pediatric Enteral Nutrition Handbook. Charlottesville: University of Virginia Health Sciences Center, 1991;37–40.

Improving Timeliness of Nutrition Intervention Through a Collaborative Quality Improvement Program in a Pediatric Intensive Care Unit

Abstract

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