J Clin Nutr.  2014 Dec;6(3):101-107.

Quality Improvement Activities for Establishment of Intestinal Rehabilitation in Intestinal Failure Patients

• Park HJ
• Lee SH
• Yoon JH
• Kim HJ
• Hong SH
• Kim EJ
• Min JK
• Kim HJ
• Jung BK
• Oh CY
• In YW
• Lee YM
• Seo JM

Abstract

PURPOSE
Intestinal failure (IF) is a complex clinical condition requiring a multi-disciplinary team approach. Our objective was to set up the treatment protocols and education documents for IF patients for development of intestinal rehabilitation programs in our hospital.
METHODS
We compared the number of inpatients, length of hospital stay, mode of nutrition and calorie supply at discharge, and the frequency of blood transfusions before and after quality improvement of multidisciplinary activities, in order to evaluate the indirect effects of new protocols and training materials and for development of the intestinal rehabilitation system.
RESULTS
We integrated eleven protocols for treatment and monitoring and seven educational materials for patients and caregivers. We compared indirect effects before and after the quality improvement activities. The number of IF patients hospitalized was reduced from 12 to 9. The mean days of hospital stay was decreased from 322 days to 73 days, the average number of monthly blood transfusions was also reduced from 1.8 to 0.3. In addition, the percentage of patients administered enteral nutrition and calories supplied was increased at discharge.
CONCLUSION
By integrating IF protocols and education materials for IF patients, we found possible indirect effects of intestinal rehabilitation using a multidisciplinary team approach.

Keyword

Intestinal failure; Intestinal rehabilitation; Team approach; Quality improvement

MeSH Terms

Blood Transfusion
Caregivers
Clinical Protocols
Education
Enteral Nutrition
Humans
Inpatients
Length of Stay
Quality Improvement*
Rehabilitation*