Nutrition therapy (NT) is important to correct protein-energy malnutrition and can help to prevent many adverse outcomes, including increased infection complication rate, impaired wound healing, longer length of hospital stay, higher treatment costs, and increased mortality.1 However, NT is not without attendant risks and adverse effects and is oriented by procedures that were systematically developed based on important scientific publications in the area and the consensual opinions of experts. 2-5One way to control protocol compliance would be through the routine practice of periodic nutrition quality control to identify possible difficulties and failures related to the application of protocols during nutrition care provided to the patient. 6,7 Therefore, in addition to the effort to develop nutrition guidelines, it is also necessary to design quality indicators in nutrition therapy (QINTs) that control the correct application of these guidelines in NT.The available guidelines comprise an elevated number of recommendations to be followed and could consequently lead to the design of an elevated number of QINTs.3-5 In 2008, the task force of clinical nutrition of the International Life Science Institute-Brazil (ILSI-Brazil) published a list of 36 QINTs and their respective national goals proposed by consensus by a group of 41 Brazilian NT specialists to attend different issues regarding national and international NT guidelines. 8 However, in addition to the scarcity of available human and material resources, the application of the 36 QINTs to clinical practice has been hindered by the high number of QINTs proposed. 9To enable the effective application of QINTs, we believe that ease of application and objectivity must be considered in addition to other factors.10,11 An excessive number of QINTs must be avoided because they may be difficult to apply Selection of Top 10 Quality Indicators for Nutrition TherapyCristiane Comeron Gimenez Verotti, RD; Raquel Susana Matos de Miranda Torrinhas, MB; Ivan Cecconello, MD, PhD; and Dan Linetzky Waitzberg, MD, PhD AbstractBackground: The identification of useful quality indicators for nutrition therapy (QINTs) is of great interest and a challenge. This study attempted to identify the 10 QINTs that best suit the practice of quality control in nutrition therapy (NT) by evaluating the opinion of experts in NT with the use of psychometric techniques and statistical tools. Methods: Thirty-six QINTs available for clinical application in Brazil were assessed in 2 distinct phases. In phase 1, 26 nutrition experts ranked QINTs by scoring 4 attributes (utility, simplicity, objectivity, low cost) to assess each QINT on a 5-point Likert scale. The top 10 QINTs were identified from the 10 best scores obtained, and the reliability of expert opinion for each indicator was assessed by Cronbach's α. In phase 2, experts provided feedback regarding the selected top 10 QINTs by answering 2 closed questions. Results: The top 10 QINTs, in descending order, are the frequency of nutrition screening o...

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Background: The identification of useful quality indicators for nutrition therapy (QINTs) is of great interest and a challenge. This study attempted to identify the 10 QINTs that best suit the practice of quality control in nutrition therapy (NT) by evaluating the opinion of experts in NT with the use of psychometric techniques and statistical tools. Methods: Thirty-six QINTs available for clinical application in Brazil were assessed in 2 distinct phases. In phase 1, 26 nutrition experts ranked QINTs by scoring 4 attributes (utility, simplicity, objectivity, low cost) to assess each QINT on a 5-point Likert scale. The top 10 QINTs were identified from the 10 best scores obtained, and the reliability of expert opinion for each indicator was assessed by Cronbach's α. In phase 2, experts provided feedback regarding the selected top 10 QINTs by answering 2 closed questions. Results: The top 10 QINTs, in descending order, are the frequency of nutrition screening of hospitalized patients, diarrhea, involuntary withdrawal of enteral feeding tubes, feeding tube obstruction, fasting longer than 24 hours, glycemic dysfunction, estimated energy expenditure and protein needs, central venous catheter infection, compliance of NT indication, and frequency of application of subjective global assessment. Opinions were consistent among the interviewed experts. During feedback, 96% of experts were satisfied with the top 10 QINTs, and 100% had considered them in accordance with their previous opinion. Conclusion: The top 10 QINTs were identified according to their usefulness in clinical practice by obtaining adequate agreement and representativeness of opinion of nutrition experts.

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