Abstract：
The Nutrition Care Process Quality Standardization and Evaluation Tool (NCP QUEST) is a validated audit instrument assessing the quality of NCP documentation by registered dietitian nutritionists. The present quality improvement project describes change in documentation quality as measured by NCP QUEST and word count of notes after a monthly national digital training provided to Veterans Affairs registered dietitian nutritionists. The training and adoption of NCP QUEST was voluntary. Facilities were recruited among those that had participated during the design and validation study of NCP QUEST. The NCP QUEST score was calculated and the word count was determined for 52 documentation notes (28 from NCP QUEST nonuser facilities and 24 from NCP QUEST user facilities) before and after training. The mean pretraining NCP QUEST score for notes from NCP QUEST nonuser facilities was 13.71 and 13.88 for NCP QUEST user facilities. The mean posttraining total NCP QUEST score for nonuser facilities was 14.00 and 17.65 for user facilities, with no improvement for the nonuser facilities (P = 0.69). A significant improvement was identified for the NCP QUEST user facilities (P ≤ 0.001). All facilities experienced a significant reduction in the word count of assessment notes (P = 0.04). Use of the electronic NCP Terminology website increased 123-fold and was sustained after the training. NCP QUEST users reported that the audit tool is useful. The NCP QUEST should be at the center of registered dietitian nutritionists\' training and more strategic effort is needed to engage practitioners in the optimal application of the NCP.
摘要：
营养护理过程质量标准化和评估工具（NCPQUEST）是一种经过验证的审核工具，用于评估注册营养师营养学家（RDN）的NCP文档质量。当前的质量改进项目描述了在向退伍军人事务（VA）RDN提供每月的国家数字培训后，通过NCPQUEST和笔记的字数衡量的文档质量变化。NCPQUEST的培训和采用是自愿的。在参与NCPQUEST设计和验证研究的人员中招募了设施。在培训前后计算了NCPQUEST分数，并确定了52个文档注释（28个来自NCPQUEST非用户设施，24个来自NCPQUEST用户设施）的字数。NCPQUEST非用户设施的训练前NCPQUEST平均评分为13.71和13.88。非用户设施的平均培训后总NCPQUEST评分为14.00，用户设施为17.65，非用户设施没有改善(P=0.69)。NCPQUEST用户设施有显著改善(P≤0.001)。所有设施的评估说明的字数显着减少（P=0.04）。电子NCP术语网站的使用增加了123倍，并在培训后得以维持。NCPQUEST用户报告说，审计工具是有用的。NCPQUEST应该是RDN培训的中心，需要更多的战略努力让从业者参与NCP的最佳应用。
