diagnóstico de mermas en fórmulas enterales (FE) y suplementos nutricionales orales (SNO) preparadas en servicio dietético de leches/central de fórmulas enterales (SEDILE/CEFE), utilizadas en pacientes adultos hospitalizados en hospital clínico San Borja Arriarán (HCSBA), Santiago de Chile

Abstract

La Nutrición Clínica (NC), ha experimentado un gran auge en los últimos años, principalmente debido a la alta prevalencia de malnutrición en pacientes hospitalizados, que se describe cercana a un 50%. Esto ha llevado al desarrollo de técnicas de nutrición artificial, entre las que se encuentran Soluciones Parenterales, Fórmulas Enterales (FE) y Suplementos Nutricionales Orales (SNO). La Fórmula Enteral (FE) es aquel producto constituido por una mezcla de macro y micronutrientes nutricionalmente equilibrada y completa que puede ser administrada por vía oral o por vía enteral. Los SNO son fórmulas nutricionales que mezclan macro y micronutrientes, completos o no en cuanto a su composición, que se ingieren vía oral por parte de pacientes que no cubren sus necesidades nutricionales con la dieta convencional. En este trabajo, nos referiremos a merma a todas aquellas formulas enterales y suplementos nutricionales orales que luego de ser planificados, preparados, distribuidos y utilizados en sala, son devueltos a CEFE (Central de Fórmulas Enterales), por alguna razón. En Chile no hay estudios publicados sobre mermas en NE y SNO utilizadas en pacientes hospitalizados. Objetivo: Realizar un diagnóstico sobre cantidad y causas de mermas provenientes de Fórmulas Enterales (FE) y Suplementos Nutricionales Orales (SNO) preparadas en SEDILE/CEFE, utilizados en pacientes adultos hospitalizados en los servicios de Medicina y Cirugía del Hospital Clínico San Borja Arriarán (HCSBA), en Santiago, entre los meses de Octubre y Diciembre del 2017 y Febrero 2018, con el fin de proponer un plan de mejoramiento para la reducción de mermas.

Introduction: Clinical Nutrition (NC), has experienced a great boom in recent years, mainly due to the high prevalence of malnutrition in hospitalized patients, which is described close to 50%. This has led to the development of artificial nutrition techniques, among which are Parenteral Solutions, Enteral Formulas (FE) and Oral Nutritional Supplements (SNO). The Enteral Formula (FE) is that product consisting of a mixture of macro and micronutrients nutritionally balanced and complete that can be administered orally or enterally. The SNO is nutritional formulas that mix macro and micronutrients, complete or not in terms of their composition, which are orally ingested by patients who do not cover their nutritional needs with the conventional diet. In this work, we will refer to reduction to all those enteral formulas and oral nutritional supplements that after being planned, prepared, distributed and used in the room, are returned to CEFE (Central of Enteral Formulas), for some reason. In Chile there are no published studies on losses in NE and SNO used in hospitalized patients. Objective: To carry out a diagnosis of the quantity and causes of losses from Enteral Formulas (FE) and Oral Nutritional Supplements (SNO) prepared in SEDILE / CEFE, used in adult patients hospitalized in the Medicine and Surgery services of the Hospital Clinico San Borja Arriarán (HCSBA), in Santiago, between the months of October and December 2017 and February 2018, in order to propose an improvement plan for the reduction of waste. Methodology: The first stage of this study consisted of the review and description of existing records in SEDILE / CEFE of HCSBA. These records correspond to: Daily enteral feeding statistics, daily statistics of ingredients calculation for NE and daily statistics of FE and SON returns during the months of October, November and December 2017 and February 2018. The second stage consisted of an internship clinic for 4 non-consecutive weeks in days and sporadic shifts (hours between 10:00 and 22:00 hrs), where the flows of the prescribed and returned FM and SNO flasks were observed, as well as the causes of shrinkage. The above was carried out in the Medicine and Surgery services of the HCSBA, during the months of November - December 2017 and February - March 2018.