Implementação da terminologia do processo de cuidado em nutrição : revisão de escopo

Abstract

The approach to nutritional care, over the years, has improved based on patient care management systems. This service must be broader and more standardized, involving clinical, biochemical, and behavioral contexts. Currently, the model of the Process of Care in Nutrition (PCN) and the Terminology of the Process of Care in Nutrition (TPCN) have been recommended. This model consists of a systematic method of solving nutrition-related problems, with standardized terms and definitions, which nutritionists use to think critically in decision-making. Thus, the purpose of this Scope Review was to map the scientific evidence about the strategies, barriers, and benefits arising from the implementation of the TPCN. The methodological assumptions of Joanna Briggs Institute - Manual For Evidence Synthesis of 2021 were adopted. A search was implemented in Medline/Pubmed databases; Scopus; Web of Science; Embase; CINHAL, FSTA, Food Science Source, and SPORTD. The sample consisted of 17 studies included, with the majority published in Australia (10 articles), United States (4 articles), Sweden (1 article), United Kingdom (1 article), and Canada (1 article). As for the methodological approaches used in the studies, the following were identified: nonrandomized trial (almost experiment) (6 studies); non-experimental study (8 studies); qualitative study (2 studies), and qualitative study/descriptive study (1 study). Three types of strategies for implementation were found (training, systems, and change management program). The benefits highlighted were: standardization of reporting and communication; better patient care; standardization/consistency of quality care and technical knowledge of guidelines/recognition by nutritionists. The barriers highlighted were: lack of knowledge, education, and training; lack of time; lack of management support, support, and planning; inadequate documentation; lack of confidence; absence of electronic system; implementation cost; lack of dissemination of TPCN; addiction to popular language and lack of motivation. It was found that the strategies used are complementary and the combination of these can lead to satisfactory results. Regarding barriers, it is noted that planning focused on education and training is essential for nutrition professionals to become familiar with the TPCN. The benefits considered by the studies allow us to understand that the implementation of the TPCN improves the practice of nutritionists