Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jan 19, 2024; 14(1): 44-52
Published online Jan 19, 2024. doi: 10.5498/wjp.v14.i1.44
Improvement of the nutritional support management system for patients in intensive care units
Yuan-Yuan Zhang, Chun-Yi Wang, Dong-Xian Guo, Hai-Nu Gao, Xian-Shan Jin, Yan-Li Wu, Lu-Han Chen, Zhi-Xian Feng
Yuan-Yuan Zhang, Chun-Yi Wang, Dong-Xian Guo, Hai-Nu Gao, Department of Critical Care Medicine, Shulan (Hangzhou) Hospital, Zhejiang Shuren University Shulan International Medical College, Hangzhou 310022, Zhejiang Province, China
Xian-Shan Jin, Department of Information, Shulan (Hangzhou) Hospital, Zhejiang Shuren University Shulan International Medical College, Hangzhou 310022, Zhejiang Province, China
Yan-Li Wu, Department of Pharmacy, Shulan (Hangzhou) Hospital, Zhejiang Shuren University Shulan International Medical College, Hangzhou 310022, Zhejiang Province, China
Lu-Han Chen, Department of Nutrition, Shulan (Hangzhou) Hospital, Zhejiang Shuren University Shulan International Medical College, Hangzhou 310022, Zhejiang Province, China
Zhi-Xian Feng, Administrative Office, Shulan (Hangzhou) Hospital, Zhejiang Shuren University Shulan International Medical College, Hangzhou 310022, Zhejiang Province, China
Author contributions: Zhang YY and Feng ZX designed the research and wrote the first manuscript, and conducted the analysis and provided guidance for the research; Zhang YY, Wang CY, Guo DX, Gao HN, Jin XS, Wu YL, Chen LH, and Feng ZX contributed to conceiving the research and analyzing data; and all authors reviewed and approved the final manuscript.
Supported by Research Project of Zhejiang Provincial Department of Education, No. Y202045115.
Institutional review board statement: This study was approved by the Ethic Committee of Shulan (Hangzhou) Hospital (Approval No. KY2021064).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data and materials are available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Xian Feng, MS, Professor, Administrative Office, Shulan (Hangzhou) Hospital, Zhejiang Shuren University Shulan International Medical College, No. 848 Dongxin Road, Gongshu District, Hangzhou 310022, Zhejiang Province, China. zhixian.feng@shulan.com
Received: October 23, 2023
Peer-review started: October 23, 2023
First decision: November 8, 2023
Revised: November 27, 2023
Accepted: December 25, 2023
Article in press: December 25, 2023
Published online: January 19, 2024
ARTICLE HIGHLIGHTS
Research background

Due to the poor standardization and compliance of nutritional support for patients by medical staff, it is difficult to achieve the goal of nutritional support for intensive care unit (ICU) inpatients.

Research motivation

This study intends to optimize the clinical nutritional support of ICU patients by constructing a nutrition support management system based on closed-loop information and psychological counseling combined with psychological interventions.

Research objectives

To explore the value of the nutritional support management system based on closed-loop information management and psychological counseling in the clinical application of ICU patients.

Research methods

Through the division of functions, personnel training, system construction, development of an intelligent decision-making software system, quality control, and improvement of the whole process, the nutritional and psychological support of ICU patients are systematically managed. In addition, the valid number of hospital stays of patients with different nutritional support methods after the implementation of systematic management, the scores of ICU nurses’ knowledge, attitudes/beliefs and practices of nutritional or psychological support, and the rate of total enteral nutrition (EN) initiated within 48 h or 72 h after admission to the ICU were counted. Moreover, the anxiety and depression of patients before and after the implementation of the project and the length of stay in the ICU were recorded.

Research results

After the implementation of the whole-process management system, the scores of nutritional or psychological support knowledge, attitudes/beliefs and practices of ICU medical staff were significantly enhanced, and the proportions of hospital bed-days of total EN and EN plus parenteral nutrition (PN) of ICU patients were significantly increased. The EN initiation rate also increased significantly within 48 h or 72 h after admission to the ICU. Moreover, markedly reduced Self-rating Anxiety Scale, Self-rating Depression Scale scores and ICU stays were observed in ICU patients after the implementation of the project.

Research conclusions

The nutritional support management system based on closed-loop information management and psychological counseling plus psychological interventions has significant advantages in the clinical application of ICU patients. It can not only improve the awareness and executive abilities of ICU medical staff, but also significantly increase the application of EN support and EN plus PN support for CU patients. Moreover, it is effective in relieving patients’ negative emotions and shortening the length of ICU stay.

Research perspectives

The nutrition support management system for ICU patients based on closed-loop information and psychological counseling combined with psychological interventions can not only improve the clinical practice of medical staff, but also optimize the medical management of ICU patients. However, there is still room for improvement in aspects such as EN initiation within 48 h of admission to the ICU, EN compliance within 72 h of admission, and negative emotional relief, warranting continuous improvement.