• Journal of Nutrition and Health
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• v.52 no.4
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• pp.332-341
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• 2019

Purpose: Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared. Methods: Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool. Results: The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools. Conclusion: This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.

• The Korean Journal of Community Living Science
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• v.15 no.2
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• pp.151-157
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• 2004

This study examined two groups of students Korean Oriental Medicine majors and Food and Nutrition majors and compared their knowledge of clinical nutrition as well as their tendency to follow healthy lifestyles. In all, 204 college juniors and seniors majoring in Food ＆ Nutrition, and 324 sophomores majoring in General Korean Oriental Medicine were given a questionnaire. Overall, knowledge of clinical nutrition(out of twenty questions) was significantly higher among the students majoring in food and nutrition (p<0.01). Specifically, these students obtained a higher score in the questions pertaining to the following topics: nutritional support(p<0.05), the relationship between menopause and blood cholesterol(p＜0.01), the relationship between weight control and carbohydrates(p＜0.01), the relationship between gout and protein(p＜0.10), the relationship between hyperlipidemia and carbohydrates(p＜0.01), the relationship between trans fatty acids and atherosclerosis(p＜0.01), the relationship between blood potassium levels and kidney disease(p<0.01), and the relationship between weight control and diet and water(p＜0.05). Conversely, students studying General Korean Oriental Medicine had a better knowledge of the relationship between malnutrition and the mortality rate and health complications(p＜0.01). The questions relating to a healthy diet and lifestyle indicated that students majoring in Food and Nutrition had higher incidences of diet irregularity and a higher missing rate (p<0.01); they were more interested in calorie content and nutrients in their diet(p＜0.05); and they were more likely to study about nutritional knowledge during their leisure time (p＜0.01). The results also indicated, however, Korean Oriental Medicine students consumed proportionally more vegetables(p<0.05); and they were more likely to take the stairs than the elevator(p＜0.01).

• Korean Journal of Clinical Laboratory Science
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• v.55 no.3
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• pp.213-218
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• 2023

When it comes to 'Team Medical Care' in Japan, clinical laboratory technologists have actively engaged in various kinds of teams, such as a diabetes team, a nutrition support team, an infection control team and a medical practice support team. Overall, with continual changes in the medical environment, clinical laboratory technologists are recently being required to not only conduct phlebotomy, specimen collection, laboratory testing, and electrocardiography, but also get actively involved in 'medical practice assistance or support' in collaboration with medical doctors and nurses. Therefore, it is anticipated that resident clinical laboratory technologists in wards or emergency rooms in Korea will be better able to contribute to improving medical quality and securing medical safety by functioning as a link to the clinical laboratory, while medical doctors and nurses will have a reduced burden of work and can dedicate themselves to better patient care.

• Journal of the Korean Dietetic Association
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• v.19 no.1
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• pp.69-81
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• 2013

The purpose of this study was to evaluate the difference in perception of clinical nutrition service (CNS) between doctors and dietitians working in hospitals in Busan and the Gyeongnam area. Research was performed through questionnaires (from November to December 2011) at over 100 beds. 73.3% of dietitians were aware of the Nutrition Support Team (NST), while only 15.6% of doctors were aware of it. Due to heavy work and lack of medical staff, doctors didn't participate in NST, although most of them recognized the necessity of NST. 61.7% of dietitians screened and managed malnourished patients, whereas only 29.8% of doctors did. The main reason dietitians didn't treat malnourished patients was the absence of a treatment system in the hospital. Less than 50% of dietitians participated in the doctor's round to malnourished patients. As for why dietitians didn't participate in doctor's rounds, 71% of doctors chose understaffed dietitians and 38.1% of dietitians chose the doctors' unawareness of the importance of the dietitian in doctor's rounds. For the lower rate of nutrition counseling in provincial regions, compared to the capital region, 46.8% of doctors cited a lack of connection between doctors and clinical dietitians, while 43.3% of dietitians cited the lack of doctors' awareness on the importance of nutrition counseling. Although 87.3% of the doctors and 91.6% of the dietitians answered that CNS is important for treatment, the perception of onsite performance status on CNS was found to be low in both groups. 48.9% of doctors and 50.0% of dietitians regarded dietitians in the hospital as personnel in charge of food services, rather a member of the medical team. To improve the awareness of the importance of the CNS, and the image of clinical dietitians, 31.2% of doctors answered "to introduce a professional dietitian license for each disease" and 26.7% of dietitians answered "to change the system in the hospital". Most subjects found that a separation of clinical nutrition services from the food service part is needed. These results suggest that it is important to narrow the difference in perceptions of clinical nutrition services between doctors and dietitians for an organized clinical nutrition management of patients in hospitals in Busan and the Gyeongnam area.

• Journal of Neurocritical Care
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• v.11 no.2
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• pp.71-80
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• 2018

Nutritional assessment and support are often overlooked in the critically ill due to other urgent priorities. Unlike oxygenation, organ dysfunction, infection, or consciousness, there is no consensus of indicators. Making it difficult to evaluate the effectiveness of an intervention. Nevertheless, appropriate nutritional support in the critically ill has been associated with less morbidity and lower mortality. But, nutritional support has been considered an adjunct, for body weight maintenance and to help patients during the inflammatory phase of illness. Thus, it has been assigned a lower priority, compared to mechanical ventilation or hemodynamic stability. Recent findings have shown that nutritional support may prevent cellular injury due to oxidative stress and help strengthen the immune response. Large-scale randomized trials and clinical guidelines have shown a shift from nutritional support to nutritional therapy, with an emphasis on the importance of protein, minerals, vitamins, and trace elements. Nutrition is also important in neurocritically ill patients. Since there are few studies or recommendations with regard to the neurocritical population, the general recommendations for nutritional support should be applied.

• Nutrition Research and Practice
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• v.1 no.1
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• pp.52-56
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• 2007

This research analyzed the iron status, clinical symptoms and physical characteristics between normal and anemic group of middle school girls in the Ulsan metropolitan area. It was carried out with 237 subjects (normal 190, anemic subject 47). They were evaluated with a questionnaire and measurement of hematological indices. BMI $(kg/m^2)$ of the two groups were $19.54{\pm}2.44$ (normal girls) and $19.22{\pm}2.27$ (anemic girls). The hemoglobin concentration of the anemic girls were $10.84{\pm}1.17g/dl$ and the serum iron of the anemic girls represent $35.15{\pm}27.47{\mu}g/100ml$. The TIBC (Total Iron Binding Capacity) of the anemic girls showed significantly high to $449.30{\pm}64.87{\mu}g/100ml$. The serum ferritin of the anemic girls was $20.53{\pm}42.29{\mu}g\ell$, it represented significantly low. The symptom of 'pale face' of the anemic girls were higher than the normal girls. Hemoglobin and serum iron were negatively correlated with 'pale face'. The TIBC was negatively correlated with 'Get a cold easily'. The duration and amount of menstruation were correlated with iron status. This research is to be utilized as basic data for dietary support and nutritional education to improve their iron status.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2933-2934
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• 2014

Involvement of a multidisciplinary team in cancer care may have added benefits over the existing system of patient management. A paradigm shift in the current patient management would allow more focus on nutritional support, in addition to clinical care. Malnutrition, a common problem in cancer patients, needs special attention from the early days of cancer care to improve quality of life and treatment outcomes. Patient management teams with trained oncology dietitians may provide quality personalized nutritional care to cancer patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.1
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• pp.39-45
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• 2009

Purpose: Preterm infants are very susceptible to malnutrition because of a lack of storage of nutrients, immature digestion and metabolism, and accompanying diseases associated with prematurity. The purpose of this study was to evaluate the effects of nutritional support by the pediatric nutritional support team (pNST) on the clinical course of preterm infants in the neonatal intensive care unit (NICU). Methods: Between July 2003 and July 2006, 48 preterm infants who were admitted to the NICU at Seoul National University Bundang Hospital were included. The subjects were divided into the following two subgroups according to the presence of NST activity; pre-NST group (n=23) and NST group (n=25). Hospital records were reviewed retrospectively. Results: Forty-eight preterm babies were included (M：F=27：21; gestational age, 25~33 weeks). A dietician, pharmacists, or the pNST participated in the prescription of total parenteral nutrition (TPN) more rapidly in the NST group (p=0.000). The fasting periods and TPN administration periods were significantly decreased in the NST group compared to the pre-NST group (p=0.017 & p=0.001, respectively). The doses of calories, protein, and lipids administered via TPN were significantly increased in the NST group compared to the pre-NST group (p=0.016, p=0.000, and p=0.000, respectively). The total period on antibiotic therapy was significantly decreased in the NST group compared to the pre-NST group (p=0.007). Conclusion: Because nutritional support by the pNST is of benefit to the clinical course of preterm infants in the NICU, the pNST should recommend to improve the nutritional status and clinical outcome of preterm infants.

• Journal of Clinical Nutrition
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• v.10 no.2
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• pp.38-44
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• 2018

Purpose: Parenteral nutrition (PN) is known to provide therapeutic beneficial improvements in malnourished patients for whom enteral nutrition is not feasible. The objective of this study was to investigate the current clinical characteristics and utilization of PN in Korea. Methods: We analyzed the Health Insurance Review Agency National Inpatients Sample database from 2014 to 2016, which included 13% of all hospitalized patients in Korea. Adult patients aged 20 years or older and receiving premixed multi-chamber bag containing PN were included for this study. Patient characteristics, admission type, primary diagnosis, and hospital demographics were evaluated. SAS version 9.4 was used for data analysis. Results: From 2014 to 2016, 149,504 patients received premixed PN, with 226,281 PN prescriptions being written. The mean patient age was 65.0 years, and 81,876 patients (54.8%) were male. Premixed 3-chamber bag and 2-chamber bag PN solutions were utilized in 131,808 (88.2%) and 32,033 (21.4%) patients, respectively. The number of patients hospitalized through the emergency department were 70,693 (47.3%), whereas 43,125 patients (28.8%) were administered PN in intensive care units. In the adult PN patients, the highest primary diagnosis was malignant neoplasm of the stomach (8,911, 6.0%), followed by organism unspecified pneumonia (7,008, 4.7%), and gastroenteritis and colitis of unspecified origin (6,381, 4.3%). Overall, 34% of adult PN patients were diagnosed with malignancies, the most common being neoplasm of the stomach (17.7%), neoplasm of bronchus/lung (11.2%), neoplasm of colon (11.1%), and neoplasm of liver/intrahepatic bile ducts (10.0%). PN solutions were most frequently administered in the metropolitan area (55.0%) and in hospitals with more than 1,000 beds (23.6%). Conclusion: PN was commonly administered in older patients, with primary diagnosis of malignancy in a significant number of cases. This study is the first large-scale description of PN-prescribing patterns in real-world clinical practice in South Korea.

• Journal of the Korean Dietetic Association
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• v.20 no.3
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• pp.183-198
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• 2014

The purpose of this study was to investigate the status of clinical nutrition services provided at tertiary hospitals and general hospitals in Korea. In total, 157 questionnaires were distributed to the departments of nutrition at hospitals on September 2013. The results of this study are as follows. The median number of beds was 607 and average length of stay was 8 days. 63.1% of dietitians had over 5 years of career experience. Nutritional screening rate was 97% in tertiary hospitals but only 67.2% in general hospitals (P<0.001). The rate of equipment with computerized nutritional screening system was 100% in tertiary hospitals but 71.9% in general hospitals (P<0.001). Hospitals with the best regarding nutritional care were hospitals accredited by JCI (Joint Commission International). On the other hand, hospitals not accredited by the JCI but KOIHA (Korea Institute for Healthcare Accreditation) showed the lowest performance rate of nutritional care. Nutrition support teams (NSTs) were established in all tertiary hospitals but in only 73% of general hospitals (P<0.001). The rate of actively operating NSTs was 89% in tertiary hospitals but only 62% in general hospitals (P<0.001). There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service between hospitals. Therefore, local solutions are needed to implement nutritional programs and policies for improved service and care.