徵才與國際訊息：

Improving the Practice of Nutrition Therapy in the Critically ill: International Nutrition Survey 2008

Dear Colleague,

We are writing to invite you to participate in an upcoming international quality improvement initiative geared at optimizing nutrition practices in the critical care setting. We are hoping that your society is willing to support us in this exciting initiative.

As you may be aware, in 2007 we were successful in conducting an international survey of nutrition therapies in 156 ICUs in 22 countries across the world. The results of this survey, when contrasted to the recommendations of the Canadian Clinical Practice Guidelines (1), highlighted several opportunities for improvement and raised questions for future research.

We are aware that, for a variety of reasons, many ICUs were unable to participate in the 2007 survey, and therefore we are seeking your societies involvement so that we can work together to identify representatives from ICUs in your country who would like to participate in this survey. In 2007, the survey and all the associated materials were only available in English. We believe this language barrier may have restricted who was able to participate. Consequently, we are seeking assistance in translating the instruction manual and case report forms. We would like to know if you (or delegate) would be interested in helping with this process. The date for the international survey is Wednesday, 14 May 2008. The results of this survey will be presented at the Asia Pacific Critical Care 2008 conference to be held in Sydney, Australia, on 30 October – 2 November 2008.

Participating in the 2008 international survey will allow each ICU to compare nutrition practices to other ICUs within their country/region and across other countries. Such comparisons will lluminate differences, highlight strengths and weaknesses, and hopefully lead to practice improvements. Participation involves the dietitian (or other practitioner) working at ICUs with greater than 8 beds collecting and entering data on a minimum of 20 ICU patients using a secure web-based data collection tool. A detailed instruction manual on the data collection procedures will be provided. The data to be collected includes hospital/ICU characteristics, patient characteristics, the elements of the APACHE II score (does not need to be calculated), nutrition prescription, type of nutrition received, blood glucose, insulin, length of stay, mortality, etc. Some data will need to be collected daily for a maximum of 12 days (from date of ICU admission onwards). The average time spent for data collection and entry is approximately 2 hours per patient. Unfortunately, we are unable to offer any financial remuneration for the data collection. Rather, the participating ICUs will be provided with bench-marked performance reports that highlight their strengths and weaknesses in comparison to other ICUs in the database. We believe that this report will be of significant value to participating ICUs and the results will illuminate opportunities for improvement and ultimately, translate into improved clinical outcomes for our critically ill patients. Please see our website to review a sample site report.

We are aware of the significant time commitment required to participate in the international survey, and understand that if ICUs have already taken part in 2007 they may not have the resources available to participate again this year. The focus of the 2008 survey is to provide an opportunity for ICUs who were unable to participate in 2007 to benefit from this exciting initiative. However, all ICUs are welcome to take part regardless of if they have participated before.

Ethics approval for conducting the international nutrition survey 2008 has been obtained from the Research Ethics Board at Queen’s University, Kingston, Canada. Since this is a quality improvement initiative using retrospective data collected as part of routine care, we do not think that additional local ethics approval is needed. No patient identifiers will be entered on the web-based data collection system and all data will be presented in aggregate form only, therefore patient confidentiality will not be breached. However, you may wish to consult your local research ethics board as to the procedures that need to be completed.

Thank you for taking the time to consider our request, we hope that we can look forward to working with you. If you are interested, please see our website www.criticalcarenutrition.com for further information and examples of the instruction manual and site reports. Please feel free to contact Siouxzy Morrison at siouxzy.morrison@med.monash.au if you have any questions.

Yours Sincerely,
Daren K. Heyland, MD, FRCPC, MSc
Director
email: dkh2@queensu.ca
Tel: 613-549-6666 x3339
+61-3-9076-2607
Hospital
Australia 3004

Andrew Davies
Investigator
e-mail: A.Davies@alfred.org.au
The Alfred Hospital
Melbourne VIC

Siouxzy Morrison
Project Leader
e-mail: siouxzy.morrison@med.monash.edu.au
Tel: +61 3 9903 0280
Department of Epidemiology & Preventative Medicine
Monash University
The Alfred Hospital
Melbourne VIC Australia 3004

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