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Biomedical subjects

A M Hedberg

Publications and source records attributed to A M Hedberg.

4 recordsLinked to original sources
PubMed1999

Economic implications of an early postoperative enteral feeding protocol.

OBJECTIVE: To study the cost-effectiveness of an early postoperative feeding protocol for patients undergoing bowel resections. DESIGN: A nonrandomized, prospective, clinical trial. Surgeons elected to participate in the treatment arm before the study's outset. SUBJECTS/SETTING: Treatment (n = 66) and control (n = 159) patients were admitted to a nonprofit general teaching hospital in the Texas Medical Center for similar diagnoses and subsequent bowel resections during an 18-month period. INTERVENTION: Treatment patients who met specific inclusion criteria had a jejunal feeding tube placed during surgery. Tube feedings were initiated within 12 hours after surgery. Control patients who met the same inclusion criteria received usual care. OUTCOMES: A successful outcome was defined as a patient developing no postoperative infection. The average cost of a nosocomial infection is presented. Variable direct and total costs (fixed plus variable) are compared between patient groups. STATISTICAL ANALYSIS: Mean cost was adjusted for rate of success in each patient group according to an analytic model. The mean cost difference between groups was analyzed by independent-samples t tests. Nonparametric Mann-Whitney rank sum tests were used to determine the cost significance of a nosocomial infection. RESULTS: The average variable direct cost savings per successful treatment patient was $1,531, which required an additional variable cost of $108.30 for the dietitian's time. The protocol resulted in a total cost savings of $4,450 per success in the treatment group. CONCLUSION: An early postoperative enteral feeding protocol as part of an outcomes management program for patients undergoing bowel resection is cost-effective.

Clinical Protocols↗
PubMed1988

Nutritional risk screening: development of a standardized protocol using dietetic technicians.

The development of a standardized screening mechanism for identifying patients in compromised nutritional status is beneficial for prompt initiation of nutrition care. A pilot screening study was conducted at St. Luke's Episcopal Hospital over a 3-month period to determine the prevalence of patients meeting defined nutritional risk criteria. Dietetic technicians screened each nursing unit once, in random order, until the entire hospital had been screened. Results indicated that one-third of the 225 patients screened were at nutritional risk. From those results, a standardized screening protocol and charting form were developed. The current screening procedure includes the original pilot study parameters of height, weight, albumin, diagnosis, and type of nutritional support, as well as additional parameters. Dietetic technicians also collect data on weight changes, appetite status, number of surgical procedures, and length of hospital stay. Criteria are listed under a severe risk or a moderate risk category. Patients meeting one severe or two moderate risk criteria are considered at nutritional risk. Recent data verify that more than one-third of patients screened are at nutritional risk. Through the utilization of technical support personnel, the standardized protocol has helped to identify patients who meet nutritional risk criteria.

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