J Clin Nutr.  2019 Dec;11(2):42-51. 10.15747/jcn.2019.11.2.42.

Analysis of Compliance and Clinical Outcomes by Expanding Physician's Departments in Pediatric Nutrition Support Team

• Lee HW
• Jung MJ
• Park JE
• Kwon H
• Kim JS
• Go H
• Son ES

• KMID: 2470081
• DOI: http://doi.org/10.15747/jcn.2019.11.2.42

Abstract

PURPOSE
Malnutrition in hospitalized children has an impact on growth, morbidity, and mortality. For this reason, the implementation of pediatric nutrition support team (PNST) has been suggested. On April 2017, in Severance Hospital, more PNST physician's departments participated in PNST, and a PNST physician assigning system was changed to be the same departments with the attending physician and PNST physician. This study performed a comparative analysis of the compliance and clinical outcomes after expanding the participation of the PNST physician's department.
METHODS
Pediatric patients, who were referred to a PNST consultant, were divided into two groups: an unmatched group (different departments with the attending physician and PNST physician [154 patients, 233 consultations from May 2016 to October 2016]), and a matched group (same departments with the attending physician and PNST physician [169 patients, 302 consultations from May 2017 to October 2017]). The PNST compliance and clinical outcomes, such as the total delivered/required caloric and protein ratio, % ideal body weight (%IBW), serum total protein, and serum albumin, in the two groups were compared.
RESULTS
The compliance was significantly higher in the matched group than the unmatched group (63.4% vs. 47.3%, P=0.005). Although there was no significant difference, the total delivered/required caloric and protein ratio, and %IBW in the matched group tended to increase. The serum total protein (0.7±0.7 g/dL vs. −0.4±1.3 g/dL, P=0.004) and serum albumin (0.5±0.5 g/dL vs. −0.1±0.6 g/dL, P=0.003) were significantly higher in the matched group.
CONCLUSION
After expanding the physician's departments in PNST, the compliance was significantly higher in the matched group and the clinical outcomes tended to better. The physician assigning system to be matched with the departments between the attending physician and the PNST physician may help increase the compliance of NST consultations, resulting in an improvement of the patient's clinical outcomes.

Keyword

Pediatrics; Nutrition support team; Parenteral nutrition

MeSH Terms

Child
Child, Hospitalized
Compliance*
Consultants
Humans
Ideal Body Weight
Malnutrition
Mortality
Parenteral Nutrition
Pediatrics
Referral and Consultation
Research Design
Serum Albumin
Serum Albumin