Impact of nutrition support teams on hospitals’ nutritional support in the largest South American city and its metropolitan area

Bottoni, Andrea; Bottoni, Adriana; Cassulino, Ana Paula; Biet, Franck; Sigulem, Dirce Maria; Oliveira, Gabriela Pardinho; Marco, Denise; Poliselli, Cristina; Rodrigues, Rita; Juzwiak, Claudia Ridel; Silva, Maria L.T. da; Castro, Isac de; Waitzberg, Dan Linetzky

doi:10.1016/j.nut.2007.11.007

Cited by 10 publications

(8 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Em 2013, um estudo que incluiu 17 hospitais públicos na cidade de São Paulo demonstrou existência de EMTN instituída em 88,2% destas instituições 15 . Entretanto, estudo anterior, que além de incluir a maior cidade do país também englobou sua região metropolitana, revelou que menos da metade dos hospitais avaliados possuíam EMTN 16 . Na região metropolitana de São Paulo, apenas cerca de um terço dos hospitais incluídos apresentavam EMTN 16 .…”

Section: Discussionunclassified

“…Entretanto, estudo anterior, que além de incluir a maior cidade do país também englobou sua região metropolitana, revelou que menos da metade dos hospitais avaliados possuíam EMTN 16 . Na região metropolitana de São Paulo, apenas cerca de um terço dos hospitais incluídos apresentavam EMTN 16 . E, quando considerados municípios menores, os dados são ainda mais alarmantes: estudo de 2014, que avaliou hospitais públicos e privados da região do Alto Tietê e Mogi das Cruzes, identificou presença de EMTN em apenas 11% dos hospitais, apesar de todas instituições incluídas relatarem utilizar NE 17 .…”

Section: Discussionunclassified

“…A implementação da EMTN deve assegurar condições adequadas de prescrição, preparação, conservação, transporte e administração da TN, além de desenvolver protocolos de acompanhamento nutricional, documentar os resultados e capacitar profissionais nesta área 1,5,6 . Com isso, a presença da EMTN tende a melhorar e aumentar a indicação de terapia nutricional enteral (TNE) e terapia nutricional parenteral (TNP) [14][15][16][17] e contribuir para minimizar possíveis inadequações na TN, como: under ou overfeeding, tempo de jejum prolongado para procedimentos, início tardio do suporte nutricional, e auxiliar no manejo do ajuste da TN, conforme surgem complicações decorrentes da doença e/ou complicações relativas à própria TN, seja metabólica, mecânica ou gastrointestinal 18 . Infelizmente, as taxas de indicações de TNE e TNP continuam inferiores às esperadas, mesmo com as elevadas taxas de desnutrição relatadas 14 .…”

Section: Introductionunclassified

“…A presença da EMTN parece ainda não ser a realidade de todos os hospitais brasileiros e, quando existentes, grande parte dos profissionais está disponível apenas uma fração do seu tempo de trabalho nesta função 16 . A literatura carece de dados atuais sobre a situação das EMTN dos hospitais brasileiros.…”

Section: Introductionunclassified

See 3 more Smart Citations

Quem Nutre? Uma pesquisa sobre as EMTNs do Brasil

Campos¹,

Ceniccola²,

Toledo³

et al. 2020

Braspen J

View full text Add to dashboard Cite

Introduction: The excellence of Nutritional Therapy (NT) for hospitalized patients requires the existence of a Multiprofessional Nutrition Therapy Team (EMTN). The implementation of a EMTN in Brazilian hospitals is mandatory according to the National Health Surveillance Agency (ANVISA), since the publication of Ordinance 272 of 1998. The EMTN must be constituted by at least one doctor, one dietitian, one nurse and one pharmacist, qualified and with specific training in NT. Despite all efforts to develop NT in Brazil, the prevalence of malnutrition remains high. NT when performed by EMTN is associated with reduced complications and costs. The presence of EMTN still does not seem to be the reality of all Brazilian hospitals. Objective: The present study aims, by means of an electronic questionnaire, to determine the existence and the current situation of the EMTN in public and private hospitals in Brazil and to define the profile of the professionals who work in the EMTN. Methods: Study carried out using a survey-type electronic questionnaire. The REDCap program was used to record responses. Results: 115 Brazilian hospitals participated, of which 80% declared having EMTN, being present in all regions of the country, with greater prevalence in the Southeast region and in large hospitals. Regarding the use of NT, it was found that institutions with EMTN have a higher average use of Enteral NT (31.9 patients) and Parenteral NT (4.3 patients). There was also a greater use of oral supplements in hospitals with EMTN (37 patients) when compared to hospitals without EMTN (18.4 patients).In almost half of the institutions, work at EMTN is not the exclusive activity of these professionals. Conclusion: EMTN are not yet a reality in all large hospitals in Brazil. A broader study can help to clarify this scenario and propose strategies for the strengthening of NTMS and NT.

show abstract

Section: Discussionunclassified

Section: Introductionunclassified

See 2 more Smart Citations

Quem Nutre? Uma pesquisa sobre as EMTNs do Brasil

Campos¹,

Ceniccola²,

Toledo³

et al. 2020

Braspen J

View full text Add to dashboard Cite

show abstract

“…For example, in 1997, approximately 20% of the hospitals in São Paulo had NTTs, and by 2008, this number had doubled. 11 Nonetheless, these levels are still less than the requirements established by law, and NTTs are mostly available at medium-and large-sized private hospitals where the necessary supplies and equipment are more readily available.…”

Section: Research-article2015mentioning

confidence: 99%

Strategies for High‐Quality Nutrition Therapy in Brazil

Waitzberg

Correia

2015

J Parenter Enteral Nutr

Self Cite

View full text Add to dashboard Cite

It is a great honor to present the 2015 Rhoads Lecture and to discuss strategies for high-quality nutrition therapy (NT), as well as to address the problem of malnutrition in Brazilian hospitals.Dr Rhoads is known for his outstanding achievements in nutrition care, and his unquestionable legacy is demonstrated by the translation of his many scientific papers and books into several languages. The importance of artificial nutrition in the overall care of a patient is reflected in Dr Rhoads's own words: "intravenous feeding is one of the rare things in Medicine that has turned out to be better than its sponsors anticipated." Moreover, when Dr Rhoads was awarded for his contributions and leadership in the field of nutrition, in his speech, he referred to a quote by Nobel laureate economist Milton Friedman: "success lies on the degree to which one's ideas and contributions become embedded in the body of knowledge that comprised one's discipline."1 Indeed, we are here to confirm the veracity of this statement regarding Dr Rhoads's scientific contributions.Accumulating evidence supports the utmost relevancy of artificial nutrition, including oral nutrition, enteral nutrition (EN), and parenteral nutrition (PN), as one of the cornerstones of patient care. Nonetheless, for the full success of NT to be achieved, it is imperative that standardized procedures be followed to prevent life-threatening associated complications and, above all, to avoid the "one-size-fits-all" practice of nutrition, which should be condemned by those following the evidence behind science. History of NT in BrazilHere, the steps that have helped Brazil implement an NT practice are presented and discussed. The statements herein are based on the experience and data of the authors, although we also acknowledge and cite the work of other professionals who have contributed to the development of NT practice in Brazil. In combination, these scientific data highlight the importance of applying advances in laboratory research to the clinical setting to improve patient care. First, we review the history of clinical nutrition in Brazil, with a particular emphasis on the role of nutrition screening and nutrition assessment as demonstrated by a malnutrition prevalence study that encompassed 4000 patients.2 Next follows a discussion of to whom, when, and what NT should be administered, particularly regarding immunonutrition and parenteral lipid emulsions. Finally, strategies that have been used to implement hospital clinical nutrition are presented, with a focus on patients with short bowel syndrome (SBS) and obesity. The outcomes, costs, quality control, and education in clinical practice that are currently involved with these strategies are also presented, as well as how these strategies have the potential to affect perspectives.Very briefly, Brazil is a country that has approximately 200 million inhabitants, 10% of whom are elderly. Life expectancy AbstractStrategies for improving nutrition therapy (NT) are of utmost importance in any healthcare system. The ...

show abstract