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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Improvement of the nutritional support management system for patients in intensive care units
Yuan-Yuan Zhang, Chun-Yi Wang, Dong-Xian Guo, Hai-Nu Gao, Xian-Shan Jin, Yan-Li Wu, Lu-Han Chen, Zhi-Xian Feng
Yuan-Yuan Zhang, Chun-Yi Wang, Dong-Xian Guo, Hai-Nu Gao, Department of Critical Care Medicine, Shulan (Hangzhou) Hospital, Zhejiang Shuren University Shulan International Medical College, Hangzhou 310022, Zhejiang Province, China
Xian-Shan Jin, Department of Information, Shulan (Hangzhou) Hospital, Zhejiang Shuren University Shulan International Medical College, Hangzhou 310022, Zhejiang Province, China
Yan-Li Wu, Department of Pharmacy, Shulan (Hangzhou) Hospital, Zhejiang Shuren University Shulan International Medical College, Hangzhou 310022, Zhejiang Province, China
Lu-Han Chen, Department of Nutrition, Shulan (Hangzhou) Hospital, Zhejiang Shuren University Shulan International Medical College, Hangzhou 310022, Zhejiang Province, China
Zhi-Xian Feng, Administrative Office, Shulan (Hangzhou) Hospital, Zhejiang Shuren University Shulan International Medical College, Hangzhou 310022, Zhejiang Province, China
Author contributions: Zhang YY and Feng ZX designed the research and wrote the first manuscript, and conducted the analysis and provided guidance for the research; Zhang YY, Wang CY, Guo DX, Gao HN, Jin XS, Wu YL, Chen LH, and Feng ZX contributed to conceiving the research and analyzing data; and all authors reviewed and approved the final manuscript.
Supported by Research Project of Zhejiang Provincial Department of Education, No. Y202045115.
Institutional review board statement: This study was approved by the Ethic Committee of Shulan (Hangzhou) Hospital (Approval No. KY2021064).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data and materials are available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Zhi-Xian Feng, MS, Professor, Administrative Office, Shulan (Hangzhou) Hospital, Zhejiang Shuren University Shulan International Medical College, No. 848 Dongxin Road, Gongshu District, Hangzhou 310022, Zhejiang Province, China. zhixian.feng@shulan.com
Received: October 23, 2023
Peer-review started: October 23, 2023
First decision: November 8, 2023
Revised: November 27, 2023
Accepted: December 25, 2023
Article in press: December 25, 2023
Published online: January 19, 2024
BACKGROUND
Nutritional support for patients hospitalized in the intensive care unit (ICU) is an important part of clinical treatment and care, but there are significant implementation difficulties.
AIM
To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.
METHODS
The division of functions, personnel training, system construction, development of an intelligent decision-making software system, quality control, and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.
RESULTS
Following the implementation of the whole process management system, the scores of ICU medical staff’s knowledge, attitudes/beliefs, and practices regarding nutritional support were comprehensively enhanced. The proportion of hospital bed-days of total enteral nutrition (EN) in ICU patients increased from 5.58% to 11.46%, and the proportion of EN plus parenteral nutrition increased from 42.71% to 47.07%. The rate of EN initiation within 48 h of ICU admission increased from 37.50% to 48.28%, and the EN compliance rate within 72 h elevated from 20.59% to 31.72%. After the implementation of the project, the Self-rating Anxiety Scale score decreased from 61.07 ± 9.91 points to 52.03 ± 9.02 points, the Self-rating Depression Scale score reduced from 62.47 ± 10.50 points to 56.34 ± 9.83 points, and the ICU stay decreased from 5.76 ± 2.77 d to 5.10 ± 2.12 d.
CONCLUSION
The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients.
Core Tip: Nutritional support for patients hospitalized in the intensive care unit is an indispensable part of clinical treatment and care, but there are problems in achieving nutritional support goals. This study has launched a nutrition support management system based on closed-loop information management and psychological counseling to try to address this issue and has made some progress.
