NST(Nutrition Support Team)

What is NST

An abbreviation for Nutrition Support Team, this team is responsible for overall nutritional therapy within the hospital and specializes in nutrition for individual patients. Our hospital doctor does not have full-time staff, but is called a doctor Registered Dietitian system. A wide variety of occupations, including therapists, speech pathologists, dental hygienists, and clerical staff in the medical affairs and general affairs departments, are working concurrently with their main jobs. The whole team then thinks about, re-evaluates, and treats the nutritional therapy of the patient who received the consultation.
Specifically, ward nurses report on the current status of patients who receive consultations, clinical laboratory technologists interpret test data and propose additional tests if necessary, and pharmacists check the effects of drugs. , doctor, Registered Dietitian nurses decide the nutritional therapy policy, and pharmacists for TPN (central parenteral nutrition) and PPN (peripheral parenteral nutrition), and registered Registered Dietitian for EN (tube feeding) and oral nutrition If you have diarrhea or decreased gastrointestinal motility, the pharmacist will suggest a drug, and the doctor will prescribe it. This is a typical example of team medical care.

Patients who are already suffering from malnutrition, patients who want to improve their nutrition for major surgery in the future, and patients who are likely to become malnourished with a normal nutrition regimen because the current situation is extremely difficult. The target patients are diverse.
In addition, for patients with dysphagia due to cerebral infarction or other causes, a swallowing support team consisting of speech therapists, physical therapists, Registered Dietitian, nurses, doctor, and doctor provides better training, Consider your diet. For patients who have difficulty in oral care, we have an oral care team consisting mainly of doctor, dental hygienists, and nurses, and for patients with pressure ulcers, we mainly consist of plastic surgeons, Dermatology, and WOC nurses. The pressure ulcer countermeasure team will use their wisdom to provide care and help.

Nutritional therapy does not produce immediate visible results, but proper nutritional therapy is a prerequisite for better medical care. Nutritional therapy is sometimes an alternative to antibiotics and sometimes a companion to rehabilitation. Without nutritional therapy of adequate calories, adequate amino acid/lipid administration, and sufficient vitamins, electrolytes, and trace elements, patients in the acute phase develop auto-cannibalism, eating their own muscles for energy. So my muscles are falling, and my rehabilitation is not progressing, and I'm getting weaker and weaker. Nutritional therapy is exactly what acute care hospitals need. Appropriate nutritional therapy supports the patient's ability to heal. The effect is not immediate, but the patient gradually gets better. In addition, although TPN tends to be used indiscriminately for nutrition, TPN increases the probability of infection. And EN preserves gut immunity, protects the intestinal mucosa, and reduces infectious mortality. The longer the fasting period, the thinner the intestinal mucosa. And you will have a hard time at the start of tube and oral administration. Use the gastrointestinal tract as soon as possible and start oral feeding as soon as possible.

However, it is necessary to determine whether oral administration is possible for the target patients. First of all, we will take good care of your oral cavity so that even in the unlikely event of accidental swallowing, the damage will be as light as possible. On top of that, swallowing evaluation by the swallowing nurse in each ward, and if there is any concern, swallowing evaluation and training will be performed by the swallowing support team. In addition, the necessity of nutrients and trace elements for pressure ulcers is undeniable. Pressure ulcers are systemic diseases. In addition, the nutritional requirements of patients with chronic obstructive pulmonary disease are still poorly understood. Adequate nutrition is essential for respiratory therapy rehabilitation. Thus, the need for nutritional therapy is spreading throughout hospitals.

Our NST has a swallowing support team, an oral care team, and a pressure ulcer treatment team, and we would like to work together to provide the optimal nutritional therapy for each patient. In addition, although it is a separate team from NST, the PEG (percutaneous gastrostomy) team has recently started activities at our hospital, and it will be possible to quickly create a PEG for patients who need it in the future. PEG is often misunderstood, but if there are no problems with swallowing, it is possible to take orally and take a bath even if you have PEG. Compared to continuing tube feeding with a nasogastric tube for patients who have been on tube feeding for a long time, PEG feeding causes no discomfort in the nose and throat, facilitates swallowing training, and increases the amount of nutrition administered. The benefits are clear compared to tube feeding, which means less time spent in bed. It is expected that this will spread further in the future.

At our hospital, there are nutritional therapists certified by the Japanese Society for Parenteral and Enteral Nutrition (JSPEN) for each occupation, as well as certified dysphagia nurses and WOC nurses. We will strive to provide better nutrition for We also have many doctor who have taken Total Nutrition Therapy, and we would like to work together as a team with as many people as possible to provide better nutritional therapy to our patients.

NST Chairman Naoki Higashibeppu

Activity content

NST is doing the following activities

Conferences and Rounds Every Wednesday

For patients who have been consulted with NST by doctor and nurses that they have nutritional problems or that they may cause nutritional disorders in the future, each staff member of the NST team will provide information on the patient, We consider problems and their countermeasures and provide guidance. After that, I make rounds to each patient to check their condition, listen to their stories, and think about how to respond.
In addition, we search the weekly data of all inpatients, pick up patients who are considered to be in poor nutritional status, and examine whether the current nutrition administration situation of those patients is appropriate.

FY2013 Number of conferences: 523
490 rounds

NCM Lecture 3rd Thursday of every month

We hold study sessions to promote NST activities among all hospital staff and improve their knowledge. We also invite an external lecturer once a year to give a lecture on the latest information on NST.

Staff study session 3rd Wednesday of every month

We conduct various training sessions within our staff to improve their skills and knowledge.

Publication of NST News Once a month

​Nutrition Support Times publishes hot NST news, such as information on NST activities, study group announcements, and topics for everyone in the hospital.

Working 4th Wednesday of every month

Team members discuss NST's activities and discuss matters to be considered and problems.

NST satellite team

Currently (December 2013), 15 NST satellite teams are active as NSTs in each ward.
Through the activities of the satellite team, we can provide nutritional therapy to more patients.

FY2013 Number of conferences: 2648

NST configuration

NST member configuration

TNT (J): Total nutritional therapy (JSPEN = Japan Society for Parenteral and Enteral Nutrition accreditation)
Nutrition Support Team Professional Therapist (J): Japanese Society for Parenteral and Enteral Nutrition Certification

Relationship between NST staff and patients

NST staff exchanges and provides all kinds of information obtained from various occupations, and implements appropriate and high-quality nutritional therapy for patients with nutritional problems or those who are likely to develop malnutrition in the future, and improves QOL.・Contributes to improvement of treatment effect, prevention of complications and infections, shortening of hospital stay, and reduction of medical expenses and material costs.

Relationship between NST and patient in team medical care

At our hospital, there are many teams that provide support to patients by gathering people from various occupations in the form of team medical care.
Each of these teams interacts with other teams to provide patient support.

NST news

Study session/Academic presentation

2014 NCM lecture and staff study session schedule

　*Note: Due to schedule, the contents and dates are subject to change.

2013 NCM Lecture

2012 NCM Lecture

2011 NCM Lecture

2010 NCM Lecture

2009 NCM Lecture

List of NST conference presentations

About swallowing diet

NST Professional Therapist

Kobe University Expert Medical Staff Development Program

Application Guidelines for Nutritional Medicine Course "Hyogo NST Joint Training Program"

About NST Professional Therapist Practice

For those who wish to undergo clinical training at our hospital for the NST specialist therapist examination.

There are two ways to enroll in clinical training at our hospital.
1: Attend 40 hours only at our clinic
2: After taking a 16-hour class at the Hyogo Prefecture NST Research Association joint training program, you will receive a 24-hour practical training at our hospital.

If you take 40 hours of classes at only one clinic, you will have to come to our clinic once a month for about a year. During that time, you will receive several clinical training sessions of about 4 hours each, for a total of 40 hours.
Application requirements are as follows.

2. However, in the joint training program of the Hyogo Prefecture NST Research Association, volunteers from hospitals in Hyogo Prefecture provide 16 hours of lectures in advance, and the remaining 24 hours at each hospital, for a total of 40 hours of practical training to become an NST specialist therapist. It is a program that satisfies the eligibility requirements for the
This is a separate application once a year.

If you are interested in clinical training at our hospital, please contact us.