Cost savings of an adult hospital nutrition support team
Abstract
Objectives A hospital-based nutrition support team (NST) may need to demonstrate cost savings and quality benefits. The primary aim of this study was to determine whether an NST could show tangible cost savings (equipment, investigations, and medication costs) from managing patients considered for parenteral nutrition (PN). Secondary aims related to the quality issues of placement of PN catheters, catheter-related sepsis (CRS), duration of parenteral nutrition, and mortality. Methods An NST was formed in 1999 and worked in all adult areas of a university hospital (Leicester Royal Infirmary). Comparative data about all patients given PN were collected for 2 consecutive years (a retrospective pre-NST year and a prospective NST year). Results In the pre-NST year there were 82 PN episodes (54 patients), 665 PN days, and a CRS rate of 71% (seven infections/100 PN days). In the NST year, there were 133 referrals for PN but only 78 PN episodes (75 patients, 59% of referrals), 752 PN days, and a decreased overall CRS rate of 29% (three infections/100 PN days, P Conclusions Although the number of PN days increased with an NST, tangible cost savings of 50715 pounds sterlings were demonstrated within the NST year by avoided PN episodes and a decreased incidence of CRS. These savings justify the salaries of a nutrition nurse specialist and a senior dietitian.
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In a cohort study, after a structured training program for nurses led by the Nutrition Support Team, catheter-related sepsis rates decreased in parenteral nutrition patients from 71% pre-NST to 29% in the first year (p=0.05).
“After a structured training program for nurses led by the NST, catheter-related sepsis rates decreased in PN patients from 71% pre-NST to 29% in their first year (p ¼ 0.05).”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [164]
In that cohort study, 55 episodes of parenteral nutrition (41% of referrals) were avoided by appropriate NST assessment and rapid instigation of enteral feeding.
“Additionally, 55 episodes of PN (41% of referrals) were avoided by appropriate NST assessment and rapid instigation of enteral feeding (Level of Evidence 2þ).”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [164]
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ESPEN guidelines on nutritional support for polymorbid internal medicine patients
Gomes, F., Schuetz, P., Bounoure, L., Austin, P., Ballesteros-Pomar, M., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., Poulia, K.-A., et al. (2018) · Clinical Nutrition · doi:10.1016/j.clnu.2017.06.025 · Cited by 363 · see citing works
ESPEN guideline on nutritional support for polymorbid medical inpatients
Wunderle, C., Gomes, F., Schuetz, P., Stumpf, F., Austin, P., Ballesteros-Pomar, M. D., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.06.023 · Cited by 105 · see citing works
“In terms of arti fi cial nutritional support, a cohort study [164] demonstrated the impact of an NSTon the management of patients requiring, or referred for, PN.”
- Authors
- Kennedy, J. F., & Nightingale, J. M. D.
- Affiliations
- Leicester Royal Infirmary (GB)
- Corresponding author
- Nightingale, Jeremy M.D.
- Venue
- Nutrition
- Publisher
- Elsevier BV
- Published
- 2005-11
- Volume
- 21
- Issue
- 11-12
- Pages
- 1127-1133
- ISSN
- 0899-9007 (ISSN-L)
- OpenAlex
- W2157324503
- Cited by
- 107
- References
- 0
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 4 · 2023: 3 · 2022: 6 · 2021: 4 · 2020: 7 · 2019: 7 · 2018: 5 · 2017: 8 · 2016: 7 · 2015: 4 · 2014: 8 · 2013: 5 · 2012: 4
- FWCI
- 2.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
- Health Sciences › Health Professions › Emergency Medical Services › Central Venous Catheters and Hemodialysis
- Keywords
- parenteral nutrition, catheter-related sepsis, cost reduction, dietitians, in-hospital mortality, parenteral nutrition duration
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Catheterization, Clinical Competence, Female, Hospitals, University, Humans, Male, Middle Aged, Parenteral Nutrition, Patient Care Team, Prospective Studies, Quality of Health Care, Retrospective Studies, Time Factors, Cost Savings, Hospital Mortality, Hospital Costs
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