摘要
医院是营养不良发病率最高的地方之一,患者是营养不良发生率最高的人群。高达20%~60%的患者入院时存在营养不良,30%~80%的患者住院期间发生显著的体重丢失,提示患者住院期间发生了医源性或院内营养不良(nosocomial malnutrition,NM)或医院获得性营养不良(hospital acquired malnutrition,HAM),从而进一步加重了原有的疾病相关性营养不良(disease-related malnutrition,DRM)。无饿医院建设就是要确保患者住院期间吃到卫生、经济、营养丰富的膳食,减少饥饿及隐性饥饿,有效预防HAM;确保患者得到合理的营养治疗,有效治疗DRM。无饿医院建设是一个系统工程,包括提高对营养不良危害性的认识、研发更加便利的营养不良诊断工具、强化入院二元诊断,提高营养不良诊断率、建立NST及NSC团队、畅通营养诊治收费体系、提供RUSF及RUTF、优化检查和治疗时间、建立无饿医院考评体系、持续质量改进等。主要从四个方面推进"无饿医院"建设:(1)解决营养科学问题;(2)规范临床营养诊疗;(3)改善医疗与护理行政管理;(4)强化后勤保障。医院行政管理、临床医护、后勤保障、患者及家属一体化参与"无饿医院"建设,在全社会开展无饿医院文化宣传,努力为患者提供一个无饿、舒适的就医环境。
Malnutrition is frequently found in hospital settings with alarming high prevalence rate.Of note,hospitalized patients have highest malnutrition incidence rate among population groups.20%~60%patients have malnutrition at the time of admission,30%~80%patients have in-hospital weight loss,indicating patients have nosocomial malnutrition(NM)or hospital acquired malnutrition(HAM)during hospital stay,all of which exacerbates DRM.Hungry-free hospital(HFH)is a nutrition care delivery program,with its focus on providing high-quality patient care,to ensure patients get easy access to safe,affordable,nourishing meals during hospital tasty,to reduce hunger or hidden hunger,to efficiently prevent HAM,to ensure inpatients receive proper nutrition therapy,and to effectively treat DRM.HFH is a comprehensive program,comprising with improving recognition of the adverse effects of malnutrition,develop a simple and easy-to-use clinical diagnostic tool,reinforce multimodal strategies for nutrition screening at admission,achieve higher completion rate of nutrition assessment,setting up NST and NSC,implementing nutritional nutrition consultation costing system,provide RUSF and RUTF,optimizing clinical examination and treatment time,develop a HFH evaluation system,and implementing continuous quality improvement(CQI)in hospital.In this article,HFH program consisted of four key approaches related to HFH efficient implementation:firstly,from nutrition science point of view,standardise key terms in clinical nutrition;secondly,address and apply standard clinical nutrition care process;thirdly,improve hospital administration management.Finally,reinforce hospital catering services.HFH is a multi-level approach involving professionals in clinical setting,staffs in catering system,patients and family members into HFH.Ultimately,promotion of a multi-level approach to hospital malnutrition at society level to raise awareness of the public as a whole,maximising hospital service quality and improving patient satisfaction.
作者
石汉平
陈伟
杨柳青
丛明华
王昆华
李勇
李薇
李增宁
杨勤兵
张晓伟
周福祥
叶文锋
张骁玮
王晓琳
王欣
朱乾坤
蔡丽雅
贾平平
邓丽
贺源
吉琳琳
于恺英
赵青川
秦环龙
韦军民
朱明炜
陈俊强
杨桦
王新颖
许红霞
李涛
刘明
崔久嵬
李苏宜
陈永兵
江波
饶本强
李素云
陈春霞
刘晓倩
赵文芝
SHI Han-ping;CHEN Wei;YANG Liu-qing;CONG Ming-hua;WANG Kun-hua;LI Yong;LI Wei;LI Zeng-ning;YANG Qin-bing;ZHANG Xiao-wei;ZHOU Fu-xiang;YE Wen-feng;ZHANG Xiao-wei;WANG Xiao-lin;WANG Xin;ZHU Qian-kun;CAI Li-ya;JIA Ping-ping;DENG Li;HE Yuan;JI Lin-lin;YU Kai-ying;ZHAO Qing-chuan;QIN Huan-long;WEI Jun-min;ZHU Ming-wei;CHEN Jun-qiang;YANG Hua;WANG Xin-ying;XU Hong-xia;LI Tao;LIU Ming;CUI Jiu-wei;LI Su-yi;CHEN Yong-bing;JIANG Bo;RAO Ben-qiang;LI Su-yun;CHEN Chun-xia;LIU Xiao-qian;ZHAO Wen-zhi(Nutritional Access Group of Chinese Society for Oncological Nutrition and Supportive Care;European Society for Parenteraland Enteral Nutrition)
出处
《肿瘤代谢与营养电子杂志》
2018年第3期225-230,共6页
Electronic Journal of Metabolism and Nutrition of Cancer
基金
国家重点研发计划项目(2017YFC1309200)
关键词
医院营养不良
无饿医院
营养治疗病房
营养指导委员会
即食治疗食品
Nosocomial malnutrition
Hungry-free hospital
Nutrition care unit
Nutrition steering committee
Ready-to-use therapeutic food
作者简介
通讯作者:石汉平,电子邮箱:shihp@ccmu.edu.cn。
