Elaboration of a protocol for the management of parenteral nutritional therapy in a public hospital in Southwestern Bahia

Abstract

Parenteral nutritional therapy (NPT) is indicated to patients when the oral or enteral pathways are unable for nutrition. The correct indication, prescription, administration and monitoring, performed by the Multiprofessional Team of Nutritional Therapy, generates benefits to the patient and reduces the risk of complications. The aim of this study was to develop an NPT protocol to systematize care and direct the multidisciplinary team in flows, conducts and procedures to reduce complications to hospitalized patients. This is an observational and descriptive study, conducted in the medical and surgical clinic sectors, intensive care units and emergency of a Public Hospital in southwestern Bahia, between May 2019 and February 2021. To elaborate the protocol, the search for scientific literature was performed through the Databases PubMed/Medline, Lilacs and Virtual Health Library, later, the selection and reading of the guidelines of the Ministry of Health, ANVISA, and the Brazilian, American, Canadian and European societies was made. The main non-conformities found in the institution are related to the lack of communication between professionals and conflict in their attributions, late initiation of parenteral nutrition, errors in the prescription and indication of access route, absence of laboratory monitoring, difficulties with the evolution and discontinuation of NPT. Deficiencies in the conduct ive ofparenteral therapy were identified and supported the elaboration of a nPT management protocol, however, this is only an initial step that should be followed by the implementation in the hospital unit and the training of the entire team.