| Objective:Clinical nutrition is closely related to the prevention of diseases and the rehabilitation of patients.Reasonable nutritional support can not only improve the nutritional status of patients and the cure rate of diseases,but also enhance the comprehensive level of medical institutions.In order to further understand the construction progress of clinical nutrition department in China,this study analyzed the quality control data of clinical nutrition department of 539 tertiary medical institutions in 26 provinces and cities nationwide,and compared the results with the "National Research Project on the Construction of Nutrition Department of Medical Institutions" conducted by the Nutrition Physician Professional Committee of Chinese Medical Doctor Association from 2016 to 2019,in order to find out the problems existing in clinical nutrition department in recent years,such as department infrastructure,department medical work,scientific research teaching and personnel training,and according to national policies and management.Methods : The clinical nutrition departments of 540 tertiary medical institutions nationwide who filled in the questionnaire from October 2021 to September 2022 were taken as the research subjects.After the questionnaire was distributed to each tertiary medical institution in the form of "questionnaire star" in the clinical nutrition quality control group of each province,the heads of clinical nutrition departments of each medical institution under their jurisdiction were guided by the quality control centers of each province to fill in the questionnaire,which was audited by the medical departments of medical institutions.After the filling was completed,the unqualified questionnaire was withdrawn and audited.The effective questionnaire was organized,and a database was established using EXCEL for double data entry,and the information was checked carefully to ensure accuracy.SPSS20.0 was used for descriptive statistical analysis of the data results.The enumeration data were expressed as mean,frequency and constituent ratio.The results after analysis of this survey were compared with the results of the "National Research Program for the Construction of Nutrition Departments in Medical Institutions" conducted by the Nutrition Doctors’ Professional Committee of Chinese Physicians Association from2016 to 2019 using chi-square test,and P< 0.05 indicated that the statistical difference was significant.Results:Compared with the results of the "National Research on the Construction of Nutrition Departments in Medical Institutions" conducted by the Nutrition Doctors’ Professional Committee of the Chinese Medical Association from 2016 to 2019,the following changes have been found in the research institutions in this study.1.Department affiliation: The management system of Nutrition Department was characterized by the coexistence of clinical,medical technology and logistics departments.The proportion of clinical departments increased from 20.30% to32.65%,that of medical technology departments decreased from 65.15% to 58.44%,and that of logistics and other departments decreased from 14.55% to 8.91%,all of which showed statistically significant differences(P<0.05).2.Staffing and related information:(1)Echelon construction: the proportion of nutrition physicians increased to 46.29%from 46.18%,that of nutrition technicians decreased to 30.71% from 31.36%,and that of nutrition nurses increased to 23.00% from 22.46%.The differences were not statistically significant(P>0.05).(2)Professional qualifications: The proportion of Ph.D.degree increased to 4.33%from 1.58%,the proportion of master’s degree increased to 25.87% from 8.53%,the proportion of undergraduate degree increased to 48.32% from 16.30%,and the proportion of specialist and other academic qualifications decreased to 21.48% from73.60%,all of which were statistically significant(P<0.05).(3)Medical bed ratio and technical bed ratio: The medical bed ratio increased from 1:549.27 to 1: 521.68,and the difference was not statistically significant(P>0.05),while the technical bed ratio increased from 1: 715.02 to 1: 623.47,and the difference was not statistically significant(P>0.05).3.the department medical business work:(1)Nutrition screening,evaluation and diagnosis: the proportion of tertiary medical institutions conducting nutrition screening increased from 78.03% to 82.56%,and the difference was not statistically significant(P>0.05);The proportion of medical institutions performing nutrition assessment was 69.02%,and the proportion of human component analyzer equipment was reduced from 38.48% to 32.28%,with statistical significance(P<0.05).(2)Enteral and dietary nutrition treatment: The proportion of tertiary medical institutions that carried out enteral nutrition treatment was reduced to 64.19% from76.06%,and the difference was statistically significant(P<0.05).The proportion of tertiary medical institutions that carried out dietary nutrition treatment was reduced to48.61%,and the difference was statistically significant(P<0.05).(3)Nutrition consultation,outpatient service and ward: The proportion of tertiary medical institutions responsible for the nutrition consultation of hospitalized patients increased from 77.58% to 92.21%,and the difference was statistically significant(P<0.05).The setting rate of nutrition outpatient service increased from 79.70% to84.04%,and the difference was not statistically significant(P>0.05).The setting rate of nutrition ward decreased from 3.49% to 1.86%,and the difference was not statistically significant(P>0.05).4.Research and teaching situation of Clinical Nutrition Department: The proportion of medical institutions undertaking clinical nutrition teaching tasks in medical colleges and universities decreased from 40.45% to 29.87%,with a significant difference(P<0.05),the proportion of medical institutions conducting clinical nutrition research increased from 35.45% to 36.92%,with a non-significant difference(P>0.05),and the proportion of medical institutions publishing professional academic papers decreased from 54.39% to 46.75%,with a significant difference(P<0.05).5.Talent cultivation: The percentages of medical institutions providing overseas and domestic continuing education and study programs were 2.97% and 45.83%,respectively.The percentages of medical institutions for professionals in clinical nutrition department continuing to study for on-the-job degrees were 21.52%,and the percentages of medical institutions participating in international and domestic academic conference exchanges related to nutrition were 4.27% and 77.92%,respectively.Conclusions:The Clinical Nutrition Department of the tertiary medical institutions in China has gradually received attention and has entered a rapid development stage.The construction and management of the Clinical Nutrition Department should be further strengthened.The latest progress in the construction of clinical nutrition department was obtained through this investigation,and the problems such as nonstandard management system of clinical nutrition department,large talent gap of clinical nutrition specialty,incomplete construction of clinical nutrition diagnosis and treatment function area,insufficient strength of clinical nutrition teaching and scientific research were found.The management system should be standardized,the structure of talent team should be reasonably optimized,the diagnosis and treatment function area should be comprehensively constructed,and the nutrition teaching and scientific research should be strengthened. |
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