Checklist and Decision Support in Nutritional Care for Burned Patients
Abstract
Our Study/Product Aim(s) were as follows: 1) To determine compliance with nutritional goals in severely burned adults, 2) To find strategies to address identified gaps in feeding, and 3) To develop and test a system that incorporates the above strategies. The proposed system would provide points in a checklist for provider attention and decision support guidelines to meet nutritional goals. For the project. we expended significant effort in obtaining approval, auditing, and analyzing data from several hundred severely burned subjects treated in the ICU from 3 centers. The current analysis using data collected without DoD funds, but the approval process, auditing of the data, and analysis was all done with time allocated to the grant, showed that initiation of tube feedings was within the first 24 hours in the majority, but the patients underwent 3+-3 operative procedures and in 53% of the hospital days tube feedings were held for clinical reasons, and restarted with only a minor effort to increase feedings to meet nutritional recommendations. Further, we found on average that patients received below the average daily caloric intake for normal persons despite increased needs associated with injury and hypermetabolism. This was associated with significant weight loss and hypoalbuminaemia. These data demonstrate that a decision support system to meet nutritional recommendations is clearly needed that could be done with a decision-support software package. The SOW was not completed as the Pl has moved to another institution. Work will continue without the use of DoD funds to complete the goals of the project.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 2018
- Accession Number
- AD1061921
Entities
People
- Steven E. Wolf
Organizations
- University of Texas Southwestern Medical Center