High frequency of non-compliance with quality indicators during oral nutrition support in hospitalized patients.

BACKGROUND & AIMS: Quality indicators are important tools in clinical practice for assessing and monitoring the quality of care in nutritional therapy. Application of these indicators can improve care and may help to decrease the high frequency of malnutrition and associated hospital costs. Therefore, the purpose of the present study was to estimate the frequency of oral nutritional supplements (ONS) use and to evaluate compliance with the four available quality indicators in oral nutritional therapy (QIONT) in a university hospital. METHODS: A prospective study was conducted from November 2017 to May 2018, using data from all patients with an ONS prescription aged 18 years or older admitted to the medical clinical or surgical clinical wards. Four indicators were investigated, as recommended by the International Life Science Institute. RESULTS: Of the 727 hospitalized patients in the included wards, 214 were on ONS. The frequency of ONS prescription was 29.4%. Of the 4 QIONT evaluated, none achieved the goals: frequency of subjective global assessment and reassessment nutritional (48.1% and 5.6%, respectively); frequency of non-compliance for the indication of ONS (73.36%); and fasting over 24 h during ONS (50%). CONCLUSION: A high frequency of non-compliance (100% of QIONT) was observed in hospitalized patients on ONS in medical clinical and surgical clinical wards. These results will enable health professionals in the evaluated service to elaborate protocols to improve the evaluation and recording of the nutritional follow-up of hospitalized patients on ONS. This will help to improve the quality of nutritional care.

High Frequency of Non-Compliance with Quality Indicators of Enteral and Parenteral Nutritional Therapy in Hospitalized Patients.

Quality indicators in nutritional therapy (QINT) are measures of the effectiveness and quality of nutrition support. The purpose of this study was to evaluate the frequency of the QINT adequacy of Enteral Nutritional Therapy (EN) and/or Parenteral (PN) in hospitalized patients and identify the best indicators according to health professionals. A prospective study was performed, including data from patients aged 18 years or over admitted to clinical or surgical wards. The patients who had received EN and/or PN were followed from the first day of nutritional prescription until discharge. Twelve indicators were calculated, as recommended by the literature. Regarding professional opinion, the QINT adequacy was evaluated by observing its utility, simplicity, objectivity, and cost. Of the 727 hospitalized patients, 101 were on EN and/or PN. Regarding the 12 QINT evaluated, only 25% (3) achieved the goals: involuntary withdrawal of enteral feeding tube (0.01%); feeding tube occlusion or withdrawal per occlusion (0%); the measurement of energy and protein requirements (92%). A high frequency of non-compliance (75% of QINT) was observed in clinical and surgical patients on EN and/or PN. With knowledge of the six best indicators chosen by health professionals in this service, it will be possible to elaborate protocols according to the real-life situation in the institution.

Effect of immersion in sodium hypochlorite on the cyclic fatigue resistance of three rotary instruments.

CONTEXT: It is essential to know if the immersion in sodium hypochlorite (NaOCl) influences the cyclic fatigue resistance of nickel-titaniumm (NiTi) files. AIM: This study was aimed to evaluate the resistance to the cyclic fatigue of three NiTi systems, as well as the influence of 5.25% NaOCl on their resistance. METHODS: Files from the Sequence Rotary File (MK life, Porto Alegre, Brazil), ProTaper Next (PTN) (Dentsply, Maillefer, Baillagues, Switzerland), and HyFlex EDM (Coltène Whaledent, Allstatten, Switzerland) systems were tested and separated into Group 1)-without immersion in NaOCl solution and Group 2 and Group 3-immersed in 5.25% NaOCl solution, for 1 min, and 5 min, respectively. All instruments were submitted to the cyclic fatigue test. Images of the instruments were observed by scanning electron microscopy, to evaluate the type of defect presented on the fractured surface. The test performed for the analysis of two independent factors was a two-way analysis of variance. RESULTS: HyFlex EDM presented a greater number of cycles until fracture when compared to others (P < 0.001). The control group showed a greater number of cycles until fracture than the same instruments submitted to NaOCl (P < 0.001). Sequence instruments showed the lowest values of cycles until fracture (P < 0.001). There was no statistically significant difference between treatments (P = 0.998). PTN, showed intermediate values of fracture resistance when compared to the HyFlex EDM and sequence instruments (P < 0.001), but without intragroup differences (P = 0.437). CONCLUSIONS: Hyflex EDM instruments were the most resistant to cyclic fatigue.

Conservação de morangos com revestimentos à base de goma xantana e óleo essencial de sálvia / Strawberries conservation with coatings based on xanthan gum and sage essential oil

Objetivou-se avaliar a conservação de morangos com revestimentos à base de goma xantana e, ou, óleo essencial de sálvia. Os morangos foram minimamente processados, submetidos aos revestimentos, secos sob ventilação, embalados em bandejas de polietileno tereftalato e armazenados a 4 ºC durante 12 dias. Foram realizadas análises de deterioração fúngica, perda de massa, firmeza, cor, pH e sólidos solúveis totais, e ao final do armazenamento, contagem de fungos e leveduras. Independente do revestimento houve redução da perda de massa dos morangos ao longo da estocagem refrigerada. Entretanto, os revestimentos à base de goma xantana indicaram ser mais eficientes, por proporcionarem maior firmeza dos frutos, sendo que aquele contendo goma xantana e óleo essencial de sálvia foi o que proporcionou a menor incidência de fungos. De um modo geral, o emprego dos revestimentos não influenciou na coloração e no pH dos frutos de morangos.

The objective was to evaluate the conservation of strawberries with coatings based on xanthan gum and, or, sage essential oil. The strawberries were minimally processed, added with coatings, dried under ventilation, packaged in trays of polyethylene terephthalate and stored at 4 °C for 12 days. Analyses of fungal decay, weight loss, firmness, color, soluble solids and pH were carried out, and at the end of storage, fungi and yeasts count as well. Regardless of the coating, mass loss of strawberries was reduced during the refrigerated storage period. However, the coatings based on xanthan gum indicated to be more efficient, by providing greater fruit firmness, while those containing xanthan gum and sage essential oil were the ones which provided the lowest incidence of fungi. In general, the coatings did not affect the color and pH of the strawberries.