Nutrition helps clinical diagnosis and treatment to promote patients’ rapid recovery
Carry out clinical nutrition diagnosis and treatment in an all-round way, promote the transformation from "nutritional diet support" to "clinical nutrition treatment", and provide strong support for patients to speed up rehabilitation, shorten hospitalization time and save medical expenses.
With the increasing demand for nutritional treatment in clinical diagnosis and treatment, and to better meet the diversified and personalized medical and health needs of the masses, in 2017, the General Office of the State Council issued the National Nutrition Plan (2017-2030), requiring medical institutions to establish a sound clinical nutrition work system, carry out nutrition screening, nutrition evaluation, nutrition diagnosis and nutrition treatment for inpatients, promote the prevention and treatment of nutrition-related chronic diseases, and promote formula food for special medical purposes (FSMP).
Over the years, based on professional development and discipline construction, the Clinical Nutrition Department of Mianyang Central Hospital in Sichuan Province has carried out clinical nutrition diagnosis and treatment in an all-round way, promoting the transformation from "nutritional diet support" to "clinical nutrition treatment", which has provided strong support for patients to speed up rehabilitation, shorten hospitalization time and save medical expenses.
From nutritional support to nutritional therapy
Chen Lan (pseudonym), 77 years old, suffered from repeated nausea and vomiting due to acute severe pancreatitis. When he went to the hepatobiliary surgery department of Mianyang Central Hospital, he had been fasting for more than 20 days. His body nutrition was maintained by parenteral nutrient solution infusion, and his weight dropped to 36 kg.
"Intestinal function has been damaged, which is not conducive to the recovery of the disease." Dong Yang, the nutritionist in charge of the clinical nutrition department of the hospital, after consultation, placed a nasointestinal tube according to his illness and nutritional status, and infused pre-digested enteral nutrition preparation for enteral nutrition treatment. At the same time, daily nutritional rounds, monitoring nutritional status, timely adjust the dose.
After more than 20 days, Chen Lan’s physical condition gradually improved, from nasointestinal tube intake to oral intake, and her daily food intake also increased, and her weight increased by 6 kg.
In recent years, in the process of disease prevention, treatment and rehabilitation, the role of nutritional therapy has become increasingly prominent, and the development of clinical nutrition has also entered the fast lane.
However, as a new discipline formed by the cross-integration of clinical medicine and nutrition, many people don’t know much about clinical nutrition therapy, and their cognition and orientation also stay in patient meal service.
In this regard, the clinical nutrition department of Mianyang Central Hospital pays attention to the combination of propaganda and practice, and takes many measures to improve the nutritional status of patients, improve the immunity of the body and promote the healing and rehabilitation of injuries.
On the basis of providing nutritional dietary services, the clinical nutrition department carries out nutritional risk screening, nutritional status evaluation, nutritional consultation, nutritional rounds, nutritional consultation, enteral and parenteral nutrition treatment, etc., not only to do a good job in dietary support, but also to participate in clinical nutritional treatment.
Through the establishment of cooperation mechanism with clinical departments, department nutritionists go deep into clinical departments and wards in different regions, consult with doctors, dynamically evaluate patients’ nutritional status, conduct precise intervention and individual guidance, and do a good job of patient nutrition "mentor" and individualized nutritional preparation "preparer" with heart.
At the same time, we actively participated in a number of Multidisciplinary Collaboration Groups (MDT) in the hospital and set up a nutrition support group, which truly realized the clinical diagnosis and treatment with nutrition and effectively promoted the rapid recovery of patients.
Informatization empowerment extension service
In order to comprehensively improve the coverage of clinical nutrition diagnosis and treatment for inpatients, in recent years, medical institutions at all levels have begun to extend the clinical nutrition diagnosis and treatment model to informationization.
How to support the efficient operation of clinical work with informatization? In 2022, Mianyang Central Hospital organized consultation among medical department, nursing department, information department, charging department and medical insurance department, and established an information process of "nutrition screening-nutrition assessment-nutrition diagnosis-nutrition treatment" in the hospital.
Specifically, nurses screen the newly hospitalized patients through the patient nutrition risk screening form and enter it into the system. Clinicians will immediately initiate consultation with nutritionists for patients with a total score of ≥3 according to the scores of various indicators in the form, and nutritionists will evaluate the nutritional status of patients and carry out nutritional diagnosis.
It can be said that the combing and establishment of the information-based diagnosis and treatment process has achieved full coverage of nutrition screening and evaluation for newly admitted patients.
In addition, in the face of complex and diverse diseases, clinical nutritional intervention should be effective, and normalized individualized nutritional therapy is essential. According to Kuang Ming, director of the Clinical Nutrition Department, in order to fully meet patients’ individualized nutritional treatment needs, last year, after the information construction of clinical nutrition diagnosis and treatment was mature and applied, his department officially opened the 100,000-class air purification enteral nutrition preparation room.
According to the metabolic characteristics of patients’ diseases, nutritionists can adjust the proportion of preparation formulas every day in the stage of "nutrition intervention" to prepare exclusive individualized enteral nutrition preparations for patients, so as to help patients recover quickly.
It is worth mentioning that in February last year, Mianyang Central Hospital was successfully selected as the national pilot unit of "Hospital Nutrition Screening, Evaluation, Diagnosis and Treatment Integrated Process Construction" by virtue of its system, function, perfect clinical nutrition diagnosis and treatment standardization and information process.
Expand the team of clinical nutritionists
Talent is the first driving force of development. In order to strengthen clinical nutrition support and ensure the quality of medical service, Mianyang Central Hospital introduced high-quality professionals, expanded the team of clinical nutritionists in the hospital, and sent nutrition professionals to study abroad to comprehensively improve the team’s ability.
The clinical nutrition department of our hospital has 7 professional technicians, presided over a provincial scientific research project, undertook a national scientific research sub-project and published more than 20 academic papers.
As a supporting department of clinical treatment, clinical nutrition department conforms to the new trend of the times and actively seeks new ways of development. In the vertical development, it aims at the level of clinical diagnosis and treatment service ability, revitalizes the construction of talent echelon, and at the same time, it insists on paying equal attention to "medical teaching and research management", promotes technology and service innovation, and leads the integrated development of departments; In the horizontal development, we actively went deep into the clinic, found and solved problems, and successively established several professional development directions, such as surgical nutrition, severe nutrition and tumor nutrition, to comprehensively promote the development of departments.
In addition to participating in clinical diagnosis and treatment, the clinical nutrition department also offers nutrition consultation clinics to provide nutrition consultation and guidance for non-hospitalized patients; Carry out family nutrition follow-up guidance for discharged patients and provide patients with life-cycle nutrition treatment services; Go into schools and communities, carry out large-scale free nutrition consultation and popular science education, and provide professional nutrition guidance for the public …
Over the years, the high-quality development of clinical nutrition department has taken solid steps, and the patient’s medical experience has been continuously improved. The hospital has been successively rated as the first sentinel hospital of the National Clinical Nutrition Professional Quality Control Center, the clinical nutrition specialty alliance unit of Huaxi Hospital, the affiliated unit of Mianyang Clinical Nutrition Quality Control Center, and the national clinical nutrition department construction pilot unit.
Kuang Ming said that the research, teaching and clinical work of clinical nutrition will be carried out in depth, the "Clinical Nutrition Action" will continue to be promoted, the workflow of nutrition diagnosis and treatment will be further improved, the talent echelon and discipline construction will be strengthened, and the service level of clinical nutrition diagnosis and treatment will be continuously improved.