Análise do suporte nutricional enteral fornecido aos pacientes críticos e não críticos de um hospital universitário antes e após intervenção educativa

Abstract

The occurrence of caloric and protein deficits in enteral nutritional therapy has been widely demonstrated in the literature and is the result of several factors that interfere with the planned supply. Among these are the improper practices of professionals in the multidisciplinary team. The training of teams involved in the administration of Enteral Nutritional Therapy has been suggested as a strategy with the potential to contribute to the adequate supply of calories and nutrients. Objectives: To analyze the effects of an educational intervention on caloric-protein supply and interruption of enteral nutritional support provided to critical and non-critical patients at a university hospital. Material and methods: Intervention study, a field experiment without a control group, carried out with nurses and nursing technicians involved in the administration of Enteral Nutritional Therapy. The training was provided by 2 nurses and 1 nutritionist from the Multidisciplinary Nutritional Therapy Team in 3 cycles throughout the intervention period (57 weeks), covering the same content. Volume, calorie and protein deficits, volume and calorie-protein adequacy, days with calorieprotein intake less than or equal to 80% of the prescribed amount and the factors that led to interruption of the diet in the pre-intervention periods were analyzed and intervention. To evaluate the effect of the intervention, the same variables were considered in the pre-intervention and intervention periods and the possible effect of the intervention was verified using mixed linear regression models. To compare the interruption frequencies for each of the factors studied, the McNamar test was used and a significance level lower than 0.05 was adopted. Results: 260 professionals participated in at least 1 of the 3 training cycles. Volume, calorie and protein deficits reduced significantly (p<0.05) in the wards from the fifth day of Enteral Nutritional Therapy after the first and second interventions. In the intensive care unit, the protein deficit reduced significantly from the fifth day onwards, also after the second intervention (p=0.035). The training also significantly reduced (p<0.05) the total number of non-compliant and inadequate days (with nutritional supply < 80%), the frequency of occurrence of interfering factors and non-conformities caused by nonexecution of the vomiting protocol. Conclusion: the educational intervention contributed to improving the quality of Enteral Nutritional Therapy offered to hospitalized patients, therefore being a valid strategy capable of increasing the efficiency and effectiveness of this therapy.