Protected time for nutrition support teams: What are the benefits?

Abstract

Nutrition support teams (NSTs) are important and unique entities in acute care hospitals. Despite their utility, NSTs are lacking in the majority of hospitals worldwide and where they exist, most members only spend a fraction of their time working within that role. We aim to evaluate the effect of protected time on NST performance by assessing the influence of structure and process in NST activities. All large public hospitals (>250 beds) in the Brazilian Federal District were evaluated with a structured questionnaire designed to assess NST performance. The questionnaire was adapted to include the Donabedian quality processes comprising 54 questions split amongst 6 domains; mainly structure and processes. The percentage of questionnaire compliance (NST outcome) was utilized to assess differences regarding structure and process. Hospitals with protected time to NST activities (Group I) were compared to hospitals without NSTs protected times (Group II). Seven hospitals were assessed. Group I, n=3, showed a significantly higher performance outcome than Group II, n=4 (77.9×60.3; P=0.004), and only Group I's score achieved the benchmark for quality standards (75% compliance). Significant differences between groups were also found in structure (P=0.017) and process (P=0.014). This study indicates that protected time for NST activities is paramount to increase NST performance and could positively influence Donabedian quality indicators. Our results highlight the importance of NSTs in large hospitals and is an advocate for public policies requiring dedicated time for NST work. Only a larger study can confirm our findings.