The Status of Enteral Nutrition Formula Use by Dietitians in Hospitals Within Busan and Gyeongnam Area

Haejin Kang, M. Woo, E. Park, Y. Park
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Abstract

This study was conducted to analyze the status of medical food selection process in hospitals within Busan and Gyeongnam area. The survey was distributed to 396 hospitals (general, tertiary and long-term care hospitals) and finally 68 surveys were used for analysis. The questionnaire consisted of 9 general items and 10 items related to enteral nutrition (EN). From the survey we found out that general hospitals and tertiary hospitals normally hire clinical dietitian, while long-term care hospitals hire dietitians with no further qualifications (χ2 = 27.918, p < 0.001). A significant relationship was found between hospital size and the priority for choosing medical foods for patients (χ2 = 11.852, p < 0.05). In general and tertiary hospitals, medical foods were provided exactly according to the doctor's prescription, whereas in long-term care hospitals, only half followed the doctor’s direction and half of them provided the products that has been conventionally used. There was also a significant relationship between hospital size and the method for determination of nutrition requirements (χ2 = 20.496, p < 0.001). Finally, the priority of considerations when developing a ‘medical food guidelines’ was shown in the following order; 1) the type of medical food that can be selected according to the disease state, 2) the nutrient content and comparison table for commercial products, and 3) how to manage complications that may occur when supplying medical food for patients. Developing an EN practice guideline for making a sensible selection of medical foods will provide a valuable information for better patient care.
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釜山、庆南地区医院营养师肠内营养配方使用情况调查
本研究旨在分析釜山和庆南地区医院的医疗食品选择过程状况。该调查被分发到396家医院(综合医院、三级医院和长期护理医院),最后使用68项调查进行分析。问卷由9个一般项目和10个肠内营养相关项目组成。从调查中我们发现,综合医院和三级医院通常雇佣临床营养师,而长期护理医院雇佣没有进一步资格的营养师(χ2=27.918,p<0.001)。医院规模与患者选择医用食品的优先级之间存在显著关系(χ2=11.852,p<0.05),医疗食品完全按照医生的处方提供,而在长期护理医院,只有一半遵循医生的指示,其中一半提供传统使用的产品。医院规模与确定营养需求的方法之间也存在显著关系(χ2=20.496,p<0.001)。最后,制定“医用食品指南”时的优先考虑事项如下所示;1) 可根据疾病状态选择的医疗食品类型,2)商业产品的营养成分和比较表,以及3)如何管理为患者提供医疗食品时可能出现的并发症。制定EN实践指南,合理选择医用食品,将为更好的患者护理提供有价值的信息。
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