Application of scoring FOCUS-PDCA cycle management in improving the accuracy of nutritional risk screening 2002 scoring among inpatients
10.3760/cma.j.cn115822-20240307-00043
- VernacularTitle:焦点循环管理法在提高住院患者NRS 2002评分准确性中的应用
- Author:
Jiajia CHEN
1
;
Wenshi WU
;
Haiyan LI
;
Ziran TANG
;
Huili WEN
;
Cuiping WU
;
Xiaojun LIU
Author Information
1. 深圳市龙华区人民医院临床营养科，深圳 518109
- Publication Type:Journal Article
- Keywords:
FOCUS-PDCA;
Nutritional Risk Screening 2002;
Accuracy;
Inpatients
- From:
Chinese Journal of Clinical Nutrition
2025;33(1):48-53
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effectiveness of find-organize-clarify-understand- select-plan-do-check-act (FOCUS-PDCA) cycle management in improving the accuracy of Nutritional Risk Screening 2002 (NRS 2002) scoring in inpatients.Methods:This study was a retrospective study. Data from a continuous quality improvement project, namely Improving the Accuracy of Nutritional Risk Screening for Inpatients from People's Hospital of Longhua in 2021 were selected. The NRS 2002 scores of newly admitted patients from 8 departments with relatively high nutritional risk (departments of gstroenterology, neurology, nephrology, respiratory medicine, oncology and hematology, neurosurgery, gastrointestinal surgery, and critical care medicine) from April 10, 2021 to April 29, 2021 (before intervention) were collected. The NRS 2002 scores were evaluated by a multidisciplinary nutrition support team in terms of accuracy and error types. Possible issues in the process of nutritional screening were analyzed and mitigated using the FOCUS-PDCA cycle management method. The NRS 2002 scores from July 18, 2021 to August 8, 2021 (after intervention) were collected in real time to summary the data on accuracy and error types and to evaluate the effect of FOCUS-PDCA.Results:The accuracy of NRS 2002 score in the 8 departments was increased from 52.97% (294/555) to 81.13% (473/583) after intervention, and the difference was statistically significant ( χ2=102.606, P<0.001). The accuracy of nutritional status impairment score was 64.14% before intervention, compared with 90.57% after intervention ( χ2=114.484, P<0.001). The accuracy of disease severity score was 78.56%, compared with 89.54% after intervention( χ2=25.736, P<0.001). The false-negative rate was 68.02% before intervention and 31.87% after intervention, and the difference was statistically significant ( χ2=31.501, P<0.001). Conclusion:FOCUS-PDCA can improve the accuracy of NRS 2002 scoring in inpatients, reduce the risk of failing to identify patients at nutritional risk, and contribute to further nutritional diagnosis and treatment.
