医疗机构特殊医学用途配方食品标准化临床路径的探索与应用  

Exploration and application of standardized clinical pathways of food for special medical purpose in medical institutions

作　　者：王蒙妍 龚杰 于凤梅[1] 陈沐熙 陈晓甜[2] 徐大凤[3] 郑丽华[4] 石磊[1] 饶志勇[1] 胡雯[1] WANG Mengyan;GONG Jie;YU Fengmei;CHEN Muxi;CHEN Xiaotian;XU Dafeng;ZHENG Lihua;SHI Lei;RAO Zhiyong;HU Wen(Department of Clinical Nutrition,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Department of Clinical Nutrition,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu 210008,P.R.China;Department of Nutrition,Chenzhou First People’s Hospital,Chenzhou,Hunan 423000,P.R.China;Department of Clinical Nutrition,the Second People’s Hospital of Yibin(West China Yibin Hospital,Sichuan University),Yibin,Sichuan 644000,P.R.China)

机构地区：[1]四川大学华西医院临床营养科,成都610041 [2]南京大学医学院附属鼓楼医院临床营养科,南京210008 [3]郴州市第一人民医院营养科,湖南郴州423000 [4]宜宾市第二人民医院·四川大学华西医院宜宾医院临床营养科,四川宜宾644000

出　　处：《华西医学》2024年第12期1905-1910,共6页West China Medical Journal

基　　金：国家市场监督管理总局特殊食品安全监督管理司委托任务(zx2013013)。

摘　　要：目的探讨特殊医学用途配方食品(food for special medical purpose,FSMP)标准化临床路径的可推广性及实施效果。方法于2023年11月10日—30日在南京大学医学院附属鼓楼医院、郴州市第一人民医院、宜宾市第二人民医院进行医疗机构FSMP标准化临床路径的试点研究,连续性纳入在3家医院使用FSMP的住院患者,分析路径的可行性和有效性。结果共纳入99例患者。路径总体效果评价显示,开具医嘱便捷(96.9%)、配送及时(100.0%)和储存不麻烦(96.9%)的比例均较高,依从性好的比例为88.9%,实现治疗目标的比例为51.5%,提前暂停使用FSMP的比例为19.2%。患者的胃肠道并发症、代谢并发症、感染并发症的发生率均较低(<30%),患者、家属和护士满意度评分的中位数(下四分位数,上四分位数)均为9.0(8.0,10.0)分。不同处方开具人员相关FSMP临床路径的流程评价指标和满意度差异均无统计学意义(P>0.05)。不同营养支持方式相关FSMP临床路径的流程评价指标和满意度差异均无统计学意义(P>0.05)。结论FSMP临床路径试点在便捷性、依从性、满意度等方面均表现良好,并发症的发生率低,路径有效且安全,可推广应用。Objective To explore the generalizability and implementation effectiveness of standardized clinical pathways of food for special medical purpose(FSMP).Methods From November 10,2023 to November 30,2023,a pilot study for the standardized clinical pathway of FSMP in medical institutions was conducted at Nanjing Drum Tower Hospital(the Affiliated Hospital of Nanjing University Medical School),Chenzhou First People’s Hospital,and the Second People’s Hospital of Yibin.The hospitalized patients using FSMP in these three hospitals were continuously included to analyze the feasibility and effectiveness of the pathway.Results A total of 99 patients were included.The overall effect evaluation of the pathway showed that the proportion of convenient medical order(96.9%),timely delivery(100.0%),and easy storage(96.9%)were relatively high.The proportion of patients with good compliance was 88.9%,the proportion of patients who achieved treatment goals was 51.5%,and the proportion of patients who suspended the use of FSMP in advance was 19.2%.The incidence of gastrointestinal complications,metabolic complications,and infectious complications in patients were relatively low(<30%),and the median(lower quartile,upper quartile)satisfaction scores for patients,family members,and nurses were all 9.0(8.0,10.0)points.There was no statistically significant difference in the process evaluation indicators or satisfaction of FSMP clinical pathways between different prescribing personnel(P>0.05).There was no statistically significant difference in the process evaluation indicators or satisfaction of FSMP clinical pathways between different nutritional support methods(P>0.05).Conclusions The FSMP clinical pathway pilot has performed well in terms of convenience,compliance,satisfaction,with a low incidence of complications.The pathway is effective and safe,and can be widely applied.

关 键 词：特殊医学用途配方食品 临床路径 医疗机构 管理 

分 类 号：R155.5[医药卫生—营养与食品卫生学]