Development of quality of care interventions for adult patients on home parenteral nutrition (HPN) with a benign underlying disease using a two-round Delphi approach

Clin Nutr. 2013 Feb;32(1):59-64. doi: 10.1016/j.clnu.2012.05.006. Epub 2012 May 30.

Abstract

Background & aims: HPN patients with benign diseases deserve professional care as they have to deal with complex techniques and risk potentially dangerous complications. The aim was to highlight main outcome quality indicators and to develop a set of key interventions to direct multidisciplinary teams in providing qualitative care.

Methods: A two-round Delphi approach was used to build consensus on the most important outcome indicators and on 59 interventions identified in existing guidelines on HPN. Comments and interventions newly identified in the first round were co-evaluated in the second round.

Results: 29 experts from 9 countries completed the two-round Delphi approach. The outcome indicators rated as the most important are 1) incidence of catheter-related infections, 2) incidence of readmission and quality of life (shared second place) and 3) incidence of dehydration. Sixty eight of a total of 89 interventions were considered as important for the quality of care, of which 46 are based on published guidelines and 22 were newly suggested by the Delphi panel.

Conclusions: Using a two-round Delphi approach, consensus was reached for the majority of interventions concerning HPN patients with benign diseases. This set of 68 interventions could be of use as a starting point for quality-improvement programs.

MeSH terms

  • Adult
  • Catheter-Related Infections / epidemiology
  • Catheter-Related Infections / etiology
  • Catheter-Related Infections / prevention & control
  • Consensus
  • Dehydration / epidemiology
  • Dehydration / etiology
  • Dehydration / prevention & control
  • Delphi Technique
  • Europe / epidemiology
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Parenteral Nutrition, Home / adverse effects*
  • Parenteral Nutrition, Home / nursing
  • Parenteral Nutrition, Home / psychology
  • Patient Care Team
  • Patient Readmission
  • Practice Guidelines as Topic
  • Professional Competence
  • Quality Improvement*
  • Quality Indicators, Health Care
  • Quality of Life
  • Societies, Scientific