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.