Combined Assessment Program: Summary Report. Enteral Nutrition Safety in Veterans Health Administration Facilities.

摘要

The VA Office of Inspector General Office of Healthcare Inspections completed an evaluation of enteral nutrition (EN) safety in Veterans Health Administration (VHA) facilities. The purposes of the evaluation were to determine whether facilities complied with Joint Commission standards and VHA requirements to: (1) establish and implement EN policies and practices, (2) manage and document EN care in the electronic health record, and (3) provide continuity of care for patients receiving EN. We also determined whether facilities incorporated selected safe EN practices as recommended by the American Society for Parenteral and Enteral Nutrition. Inspectors evaluated EN safety at 27 facilities during Combined Assessment Program reviews conducted from April 1-September 30, 2011. We identified several strengths in VHA facilities' management of EN, including documentation that encompassed flow rate and water flushes, safe storage of products, and Nutrition Service documentation. However, we identified opportunities for improvement in five areas. We recommended that the Under Secretary for Health evaluate current VHA requirements and revise them to include applicable industry recommendations regarding EN safety practices and documentation. We also recommended that the Under Secretary for Health, in conjunction with Veterans Integrated Service Network and facility senior managers, ensures that: Facilities' policies and practices address all VHA-required EN elements. Electronic health record documentation consistently includes all VHA-required EN elements. Clinicians provide EN education for patients discharged on EN and/or their caregivers. Facilities strengthen continuity of care processes for follow-up and monitoring of patients discharged on EN.