NST stands for Nutritional Support Team. It provides multidisciplinary team medical care involving doctors, nurses, pharmacists, registered dietitians, clinical laboratory technicians, etc. to support both patients and their attending doctors. We pool together our collective specialized knowledge for various diseases and try to consider better nutritional management for patients.
Along with the popularization of total parenteral nutrition, NST care spread around the United States and European countries early on, and then in Japan since 2000. In Europe and the United States, NST is usually composed of dedicated staff members. In Japan on the other hand, PPM (Potluck Party Method) is adopted in most cases. It is the way that each professional concurrently as a member of NST as well as their own department and put their heads and time together.

Nutritional therapy is important as one of fundamental medical care. Nutrient intake management is a standard therapy for metabolic disease including diabetes, and kidney disease. Regarding other diseases, nutritional therapy itself does not treat them, however, a patients’ nutritional status exerts a great influence on the therapeutic effect of other treatments.
Originally, taking meals through your mouth is a physiological behavior on nutrient intake. However, this may be difficult for some patients, unfortunately, depending on their condition. In that case, tube/enteral feeding and intravenous nutrition would be eligible. Considering intestinal function and complication(s) when nutritional therapy is performed, it is recommended that tube/enteral feeding through the intestine is performed as much as possible, rather than intravenous nutrition. It is important to choose optimal nutritional methods depending on the situation.

Our NST was established in May, 2000 as a study group. We had made elaborate preparations and it was established officially as multidisciplinary NST under the direct control of the hospital director in August, 2004. We are an accredited NST facility by the Japanese Society for Clinical Nutrition and Metabolism and Japan Council for Nutritional Therapy. We are also an authorized training facility of the Japanese Society for Clinical Nutrition and Metabolism and so we accept trainees.

Our hospital is an acute care hospital. Some patients are admitted due to scheduled medical treatments or/and operations while others need emergency hospitalization due to the onset of new disease/symptoms even though they were living a normal daily life until the previous day. There are a lot of patients who need to change their nutrition methods while hospitalized and are subject to NST intervention. We provide care rounds for about 2,400 patients a year. We hold conferences and provide patient rounds three times a week, as well as hold a lunchtime meeting once a week.
NST supports patients who cannot take required amount of nutrient estimated individually and are required to have a special alimentation and nutritional support route. We respond to various diseases and have a wide sphere of activity. Our specific activities are as follows.
- Evaluation of hypo/hyper alimentation.
- Consideration of nutritional methods and routes.
- Consideration of dietary supplements.
- Planning for administration components of enteral and parenteral nutrition.
- Response to complications which may arise during the course of nutritional therapy.

There are some other medical support teams like NST at our hospital, such as dysphagia control team under our Nutrition
Therapy Center, bedsore control team and palliative care team which belong to other organizations; we cooperate and work together. Each team involves various health professionals shown below.
- Dysphagia control team: Certified nurse in dysphagia, Speech therapist.
- Bedsore control team: Certified nurse in wound, ostomy, and continence (WOC nurse).
- Palliative care team: Certified nurse in palliative care, Certified nurse specialist in cancer nursing, Certified nurse in cancer pain management nursing, Board certified pharmacist in palliative care.
There are many cases where patients have difficulty in taking enough nutrition orally when they have a disorder of swallowing function, thus supplementary nutritional therapy is required. It is also said that additional nutrition support is necessary during the process of healing bedsores. Needless to say, in the field of palliative care, nutritional management of the content of meals and nutritional intake is important.

Our dysphagia control team began operations in 2005 with our motto “Prevent aspiration and suffocation, and avoid unnecessary fasting” for inpatients. With an aging population, patients with dysphagia has been increasing in recent years. We are an acute care hospital, so that the number of surgery for aging patients at our hospital is on the rise. Therefore, the prevention measures against aspiration pneumonia caused by perioperative dysphagia are required.
The dysphagia control team is composed of various health professionals including doctors, dentists, certified nurses in dysphagia, dietitians, pharmacists, speech therapists, dental hygienists, and office clerks. They leverage each expertise and provide patients with the following total care and support regarding “eating” throughout the course of hospitalization
- Accurate swallowing evaluation for patients with suspected dysphagia.
- Specialized swallowing rehabilitation
- Support for oral intake with proper food form.
- Cooking instructions of dysphagia diets for patients and their families when the patients are scheduled to be discharged.
We strive to cooperate with other medical facilities in our community by making and providing summary documents regarding food form to prevent repeated aspiration when our patients are transferred to other facilities.