Clinical Decision Support for Adult Enteral Nutrition: Literature Overview and Preliminary Hospital-Based Evaluation.

RATIONALE: Clinical Decision Support Systems (CDSS) are increasingly used to enhance medical decision-making, including nutrition support.

OBJECTIVE

This study aimed to narratively review CDSS tools for enteral nutrition (EN) and to preliminarily evaluate a locally developed internal-use CDSS designed to calculate patients' nutritional requirements and assist in the selection of EN and oral nutritional supplements (ONS) in adult hospitalized patients.

METHODS

Literature search was conducted in PubMed to identify existing CDSS tools used for assisting EN. Additionally, the internal-use CDSS was pilot-tested in 27 adult inpatients admitted to a private hospital in Athens, Greece. Differences in the time required to prepare the manually derived EN/ONS plan and the CDSS-derived plan were recorded. Discrepancies between the two approaches were assessed.

RESULTS

Fourteen studies were identified. Although the results were inconsistent, the application of a CDSS seems to reduce calculation time, increase dietitian referrals, initiate faster enteral feeding, improve nutrient delivery, decrease nutritional risk and was associated with fewer feeding-related medical errors. In the pilot-test of the internal-use CDSS, the time required for nutrition planning decreased from 9.01 ± 0.21 min to 4.01 ± 0.35 min per patient. The CDSS and manual approach selected the same EN/ONS products in 66.7% of the cases.

CONCLUSION

Implementing CDSSs in hospitals may streamline workflow, reduce calculation errors and shorten the time needed per patient. The specific CDSS may reduce the time required for EN/ONS planning and may help standardize formula selection in adult hospitalized patients. These findings require confirmation in larger, multicenter studies with predefined clinical and workflow outcomes.