构建院内营养不良管理体系,建设“无饿医院”

Construction of malnutrition management system in hospital:an introduction to hunger-free hospital programme

《“健康中国2030”规划纲要》《国民营养计划(2017—2030年)》从国家政策层面确立了营养在健康中国建设中的重要作用。为加强患者营养不良管理,2018年10月,首都医科大学附属北京世纪坛医院在国内率先启动“无饿医院”建设,在建设医院营养不良管理体系、建立营养不良管理体系建设技术路线、完善多部门联动机制、规范诊疗行为、严格执行营养管理规范、提升营养管理理念、构建营养闭环管理机制等方面积极探索。实施1年后,肿瘤患者双诊断率,营养筛查比例,营养会诊比例,营养筛查阳性患者进行营养评估比例,医疗文书中记录营养筛查、评估、治疗的内容比例明显提升;分析单纯肠内营养治疗、肠内营养治疗联合营养会诊可明显降低住院费用,降低并发症发生风险。由此得出,医院通过创新营养治疗理念及管理模式和机制,营养不良管理体系基本形成并初显成效,营养不良患者可从“无饿医院”管理模式中获益;建设“无饿医院”具有重大意义。

In“Healthy China 2030”planning outline and national nutrition plan(2017—2030),the important role of nutrition has been established in the construction of healthy China from the national policy level.In October 2018,to strengthen malnutrition management of patients,we took the lead in starting up the hunger-free hospital programme in China.We explored actively in constructing the hospital malnutrition management system,establishing the technical route of malnutrition management system,improving the multi-department linkage mechanism,standardizing diagnosis and treatment,implementing nutrition management standard strictly,improving the concept of nutrition management and establishing closed-loop nutrition management mechanism,and etc.After implementation of one year,we analyzed indexes such as ratio of dual diagnostic for cancer patients,ratio of nutritional risk screening,ratio of nutritional assessment for patients with positive nutrition risk screening,and ratio of nutritional consultation and nutritional treatment.We also focused on the medical documents records about nutritional screening,nutritional assessment and therapy.The proportion increased significantly.The indexes also suggest that simple enteral nutrition therapy and enteral nutrition therapy combined with nutrition consultation can reduce hospitalization costs and the incidence of postoperative complications.It can be concluded that the positive effect of management has emerged obviously through the innovation of nutrition treatment concepts,management models and mechanisms.Malnutrition management system has achieved initial results.Malnutrition patients can benefit from the mode of hunger-free hospital programme.Hunger-free hospital programme is of great significance.