Vol. 35, pp , 2007 NST : NST NST NST NST NST NST NST NST. Ver. 5. nutrition support team: NST NST NST

Transcript

1 151 Vol. 35, pp , 2007 NST : nutrition support team: NST NST NST NST NST NST NST NST NST nutrition support team: NST NST NST 3 NST Ver. 5 NST 1 NST NST NST NST 25

2 152 NST NST NST NST 1970 total parenteral nutrition: TPN 2 QOL, 3 NST NST 30 NST 4 NST NST potluck party method: PPM NST PPM NST NST NST NST NST 1 NST TPN IVH&ED NST NST NST NST Figure 1 NST NST NST NST 1 NST Japanese Society for Parenteral and Enteral Nutrition: JSPEN NST NST NST NST JSPEN TNT total nutrition therapy TNT NST NST 26

3 activity of nutrition support team 153 Figure 1. The formation of the nutrition support team in St. Marianna University School of Medicine, Yokohama City Seibu Hospital NST TPN NST NST NST Figure BMI body mass indexkgm 2 BMI NST

4 154 Figure 2. The ratio of inspected operations related to nutrition in each department. Table 1. Investigation of Weight Measurements Before the NST Began Operations. Table 1 NST NST NST NST NST Harris-Benedict 8 NST NST NST TNT 48 NST NST NST 28

5 activity of nutrition support team 155 Table 2. The Nutritional Circumstances of the Patients Requested by the NST NST NST NST NST NST NST NST NST NST 2 NST NST 4 Table 2 BMI body mass index, IBW ideal body weight, TSF triceps skin fold,, AMC arm muscle circumference, TSF AMC JARD Japanese Anthropometric Reference Data 2001 NST 4 NST NST NST NST NST Table 3 NST ASPEN American Society for Parenteral and Enteral Nutrition TPN, 2 NST 29

6 156 Table 3. The Ratio of Order Reflections by the Doctors from the NST s Recommendations GFO evidence based nutrition pharmaconutrients 10 NST NST 60 NST 11 NST NST NST gkghr NST

7 activity of nutrition support team 157 NST VF Video Fluorography, VEVideo Endscopy 20 NST NST 6 NST NST 4 NST NST NST NST NST NST NST Table 4 NST Table 5 NST NST 1 NST NST NST ADL QOL, NST Figure 3 TPN enteral nutrition: EN NST TPN NST TPN 19 NST TPN TPN NST NST 22 31

8 158 Table 4. The Ratio of Energy Su$ciency of the Patients Requested by the NST Table 5. The Changes of Objective Nutritional Indicators Classified by Diseases Figure 3. The monthly transitions of TPN and EN controlled patients both before and after the commencement of NST PPM potluck party method NST NST 200 NST NST 4 NST 32

9 activity of nutrition support team 159 NST NST NST NST NST TPN NST NST NST NST NST NST ASPEN 24 NST NST NST NST NST TPN 13 NST 4 NST NST 4 NST NST NST NST NST 25 QOL, PS Performance Status NST NST NST 33

10 160 NST Blackburn GL, Bothe A, Lahey MA. Organization and administration of a nutrition support service. Surg Clin North Am. 1981; 61: Sheridan, J. F. and Calvert, F. S The nutrition support team Results of a comprehensive hospital survey. Ross Laboratories, Columbus, Ohio, Potluck party method NST 2000; 17: ; 14: Charney P: Nutrition assessment in the 1990 s, where are we now?. Nutri clin prac 1995; 10: ; 6: Harris W, Benedict F. A biometric study of basal metabolism in man. Carnegie Institution of Washington 1919; Journal of Parenteral and Enteral Nutrition An international journal of nutrition and metabolic support 26 1 Supplement, JPEN 2002; January-February: Heyland DK, Novak F, Drover JW. Should immunonutrition become routine in critically ill patients? A systematic review of the evidence. JAMA 2001; 286: nutrition support journal 2004; 14: Fischer GW, Hunter KW, Wilson SR, Mease AD. Diminished Bacterial Defenses with Intralipid. The Lancet 1980; 2: IVH 2000; 36: ; 168: ACE 2000; 36: Rapid turnover protein 2004; 27: ; 22: ; 54: NST &ICT ; 21: Moore FA, Feliciano DV, Andrassy RJ, McArdle AH, Booth FV, Morgenstein-Wagner TB, Kellum JM Jr, Welling RE, Moore EE. Early enteral feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta-analysis. Ann Surg 1992; 216: Kotler DP, Fogleman L. Comparison of total parenteral nutrition and an oral, semi elemental diet on body composition, physical function, and nutrition-related costs in patients with malabsorption due to acquired immunodeficiency syndrome. JPEN 1998; 22: Nehme AE. Nutrition support of the hospitalized patient :the team concept. JAMA 1980; 16: NST 2001: Journal of parenteral and enteral nutrition an international journal of nutrition and metabolic support vol 26 No1 supplement, January- February Payne-James JJ: Cost-e#ectiveness of nutritional support teams. Are they necessary? Nutrition 1997; 13:

11 activity of nutrition support team 161 Abstract Starting up a nutrition support team NST and its achievements during the first 4 years at St. Marianna University School of Medicine, Yokohama City Seibu Hospital Hiroyuki Hayashi 1, 2, Hiroyuki Komoriyama 2, Minoru Miyashita 2, Suzumi Soh 2, Yukiko Kawashima 2, Sonoko Sawafuji 1, 2, Misako Kawase 2, Hiroyuki Abe 2, Kumiko Hamada 2, Takahito Yamamoto 2, Akeo Nakazawa 2, and Hiroshi Suzuki 2, 3 St. Marianna University School of Medicine, Yokohama City Seibu Hospital, was established in 1987 admitting patients in their acute phase. This 518 bed hospital has operated a nutrition support team NST since September In this article, the origins of the NST and the details of the system inside the hospital are described. An investigation of the sta# s awareness, the ratio of inspected operations related to nutrition in each department, and the ratio of weight measurements are reported as nutritional circumstances before the NST began operating in this hospital. The necessity for improving the skills of the doctors, nurses, pharmacists, registered dieticians, and rehabilitation department as a whole, is discussed. Each and every nutritional plan requested by the doctors, and designed for the patients has been presented by the NST. In this article, the nutritional plans presented were classified by nutritional management methods, nutritional quantities, nutritional compositions, speed of administration, diet content, and inspected operations related to nutrition. The results were then collated and analyzed. In addition, patients who were requested by the doctors in charge were divided into various groups, such as cancer, trauma, cerebral vascular disease, etc. and the changes of their nutritional status were noted after intervention by the NST, using albumin as a nutritional indicator. In the worldwide recommendation of enteral nutrition, where costs and safety are concerned, the changes in nutritional management methods are described by the NST. I believe that the retrospective study of this article will help connect the maintenance and quality improvement of the NST functions and also help ingrain the NST functions that each type of occupation deems safe and appropriate nutritional management in this hospital. 1 Department of Pharmacy, Yokohama City Seibu Hospital, St. Marianna University School of Medicine 2 Nutrition support team, Yokohama City Seibu Hospital, St. Marianna University School of Medicine 3 Kanagawa University of Human Services, Faculty of Health & Social Work, School of Nutrition & Dietetics 35