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Implementation of Dietitian Recommendations for Enteral Nutrition Results in Improved Outcomes
A primary role of the registered dietitian (RD) is to assess nutritional needs of patients in states of physiological stress and illness and to recommend changes to diet and tube feedings when warranted. However, implementation of changes is dependent upon the physician accepting the recommendations...
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| Published in: | Journal of the American Dietetic Association 2006-02, Vol.106 (2), p.281-284 |
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| cites | cdi_FETCH-LOGICAL-c501t-3141193e83006597b7f028a3621e609af80d9a94c06c7aa20f867bde7efdcb213 |
| container_end_page | 284 |
| container_issue | 2 |
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| container_title | Journal of the American Dietetic Association |
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| creator | Braga, Jennifer M. Hunt, Alice Pope, Janet Molaison, Elaine |
| description | A primary role of the registered dietitian (RD) is to assess nutritional needs of patients in states of physiological stress and illness and to recommend changes to diet and tube feedings when warranted. However, implementation of changes is dependent upon the physician accepting the recommendations of the RD. This study evaluated outcomes of two groups of enterally fed patients in a long-term acute-care facility in northwest Louisiana: (a) those for whom the physician accepted RD recommendations; and (b) those for whom the physician did not accept RD recommendations. Data showed that physician-prescribed enteral formulas provided 10.0% less kilocalories and 7.8% less protein than the RD-assessed needs.
t tests showed that when RD recommendations were implemented, patients had a significantly shorter length of stay (28.5±1.8 vs 30.5±4.8 days,
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| doi_str_mv | 10.1016/j.jada.2005.10.039 |
| format | article |
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t tests showed that when RD recommendations were implemented, patients had a significantly shorter length of stay (28.5±1.8 vs 30.5±4.8 days,
P<0.05), as well as significantly improved albumin (0.13±0.17 vs −0.44±0.21 g/dL [1.3±1.7 vs −4.4±2.1 g/L],
P<0.05) and weight gains (0.51±0.1 vs −0.42±0.2%,
P<0.05) when compared to those who continued with physician’s orders. These data suggest that if RDs had the authority to write nutrition orders and provide early nutrition intervention, patient care would improve.</description><identifier>ISSN: 0002-8223</identifier><identifier>ISSN: 2212-2672</identifier><identifier>EISSN: 1878-3570</identifier><identifier>EISSN: 2212-2680</identifier><identifier>DOI: 10.1016/j.jada.2005.10.039</identifier><identifier>PMID: 16442879</identifier><identifier>CODEN: JADAAE</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Americans ; Biological and medical sciences ; Blacks ; Clinical outcomes ; Comparative studies ; Critical Care ; Dietary Proteins - administration & dosage ; dietary recommendations ; dietetics ; Dietetics - methods ; Dietetics - standards ; Dietitians ; Energy Intake ; Enteral Nutrition - standards ; environment ; environmental factors ; Female ; food choices ; Food Service, Hospital - standards ; health promotion ; healthful ; Hispanics ; hospital diet ; hospitalized adult patients ; Hospitals, Convalescent - standards ; Humans ; Inpatient care ; Intervention ; Length of Stay ; Long-Term Care - standards ; low fat foods ; Male ; Medical sciences ; Metabolic diseases ; Middle Aged ; nutrient requirements ; Nutrition ; Nutrition Assessment ; nutrition education ; nutritional adequacy ; nutritional intervention ; patient care ; Patient Care Team ; patients ; Physician's Role ; Practice Guidelines as Topic ; Professional Autonomy ; Quality of Health Care ; Retrospective Studies ; school food service ; school lunch ; Serum Albumin - analysis ; socioeconomic status ; Treatment Outcome ; tube feeding ; Weight Gain ; Whites</subject><ispartof>Journal of the American Dietetic Association, 2006-02, Vol.106 (2), p.281-284</ispartof><rights>2006 American Dietetic Association</rights><rights>2006 INIST-CNRS</rights><rights>Copyright American Dietetic Association Feb 2006</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c501t-3141193e83006597b7f028a3621e609af80d9a94c06c7aa20f867bde7efdcb213</citedby><cites>FETCH-LOGICAL-c501t-3141193e83006597b7f028a3621e609af80d9a94c06c7aa20f867bde7efdcb213</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17534253$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16442879$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Braga, Jennifer M.</creatorcontrib><creatorcontrib>Hunt, Alice</creatorcontrib><creatorcontrib>Pope, Janet</creatorcontrib><creatorcontrib>Molaison, Elaine</creatorcontrib><title>Implementation of Dietitian Recommendations for Enteral Nutrition Results in Improved Outcomes</title><title>Journal of the American Dietetic Association</title><addtitle>J Am Diet Assoc</addtitle><description>A primary role of the registered dietitian (RD) is to assess nutritional needs of patients in states of physiological stress and illness and to recommend changes to diet and tube feedings when warranted. However, implementation of changes is dependent upon the physician accepting the recommendations of the RD. This study evaluated outcomes of two groups of enterally fed patients in a long-term acute-care facility in northwest Louisiana: (a) those for whom the physician accepted RD recommendations; and (b) those for whom the physician did not accept RD recommendations. Data showed that physician-prescribed enteral formulas provided 10.0% less kilocalories and 7.8% less protein than the RD-assessed needs.
t tests showed that when RD recommendations were implemented, patients had a significantly shorter length of stay (28.5±1.8 vs 30.5±4.8 days,
P<0.05), as well as significantly improved albumin (0.13±0.17 vs −0.44±0.21 g/dL [1.3±1.7 vs −4.4±2.1 g/L],
P<0.05) and weight gains (0.51±0.1 vs −0.42±0.2%,
P<0.05) when compared to those who continued with physician’s orders. These data suggest that if RDs had the authority to write nutrition orders and provide early nutrition intervention, patient care would improve.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Americans</subject><subject>Biological and medical sciences</subject><subject>Blacks</subject><subject>Clinical outcomes</subject><subject>Comparative studies</subject><subject>Critical Care</subject><subject>Dietary Proteins - administration & dosage</subject><subject>dietary recommendations</subject><subject>dietetics</subject><subject>Dietetics - methods</subject><subject>Dietetics - standards</subject><subject>Dietitians</subject><subject>Energy Intake</subject><subject>Enteral Nutrition - standards</subject><subject>environment</subject><subject>environmental factors</subject><subject>Female</subject><subject>food choices</subject><subject>Food Service, Hospital - standards</subject><subject>health promotion</subject><subject>healthful</subject><subject>Hispanics</subject><subject>hospital diet</subject><subject>hospitalized adult patients</subject><subject>Hospitals, Convalescent - standards</subject><subject>Humans</subject><subject>Inpatient care</subject><subject>Intervention</subject><subject>Length of Stay</subject><subject>Long-Term Care - standards</subject><subject>low fat foods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Middle Aged</subject><subject>nutrient requirements</subject><subject>Nutrition</subject><subject>Nutrition Assessment</subject><subject>nutrition education</subject><subject>nutritional adequacy</subject><subject>nutritional intervention</subject><subject>patient care</subject><subject>Patient Care Team</subject><subject>patients</subject><subject>Physician's Role</subject><subject>Practice Guidelines as Topic</subject><subject>Professional Autonomy</subject><subject>Quality of Health Care</subject><subject>Retrospective Studies</subject><subject>school food service</subject><subject>school lunch</subject><subject>Serum Albumin - analysis</subject><subject>socioeconomic status</subject><subject>Treatment Outcome</subject><subject>tube feeding</subject><subject>Weight Gain</subject><subject>Whites</subject><issn>0002-8223</issn><issn>2212-2672</issn><issn>1878-3570</issn><issn>2212-2680</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><recordid>eNp9kEFrFTEQx4NY7LP6BTzoIuhtn5Nkd5MFL1KrLRQL1V4NeclEsuxuapIt9Nub7XtQ6MFTyMzvPzP8CHlDYUuBdp-G7aCt3jKAthS2wPtnZEOlkDVvBTwnGwBgtWSMH5OXKQ3lCy2FF-SYdk3DpOg35PfFdDvihHPW2Ye5Cq766jH77PVcXaMJU-nZh16qXIjV2Zwx6rH6seToHyLXmJYxp8rPVRkWwx3a6mrJJYrpFTlyekz4-vCekJtvZ79Oz-vLq-8Xp18ua9MCzTWnDaU9R8kBurYXO-GASc07RrGDXjsJttd9Y6AzQmsGTnZiZ1Ggs2bHKD8hH_dzy_6_C6asJp8MjqOeMSxJCehkL2VfwPdPwCEscS63KUZlQxk0UCC2h0wMKUV06jb6Scd7RUGt6tWgVvVqVb_WivoSenuYvOwmtI-Rg-sCfDgAOhk9uqhn49MjJ1resJYX7t2eczoo_ScW5uYnA8qBQsclXYnPewKL0juPUSXjcTZofUSTlQ3-f5f-A_JYqqs</recordid><startdate>20060201</startdate><enddate>20060201</enddate><creator>Braga, Jennifer M.</creator><creator>Hunt, Alice</creator><creator>Pope, Janet</creator><creator>Molaison, Elaine</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>FBQ</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20060201</creationdate><title>Implementation of Dietitian Recommendations for Enteral Nutrition Results in Improved Outcomes</title><author>Braga, Jennifer M. ; Hunt, Alice ; Pope, Janet ; Molaison, Elaine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c501t-3141193e83006597b7f028a3621e609af80d9a94c06c7aa20f867bde7efdcb213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Americans</topic><topic>Biological and medical sciences</topic><topic>Blacks</topic><topic>Clinical outcomes</topic><topic>Comparative studies</topic><topic>Critical Care</topic><topic>Dietary Proteins - administration & dosage</topic><topic>dietary recommendations</topic><topic>dietetics</topic><topic>Dietetics - methods</topic><topic>Dietetics - standards</topic><topic>Dietitians</topic><topic>Energy Intake</topic><topic>Enteral Nutrition - standards</topic><topic>environment</topic><topic>environmental factors</topic><topic>Female</topic><topic>food choices</topic><topic>Food Service, Hospital - standards</topic><topic>health promotion</topic><topic>healthful</topic><topic>Hispanics</topic><topic>hospital diet</topic><topic>hospitalized adult patients</topic><topic>Hospitals, Convalescent - standards</topic><topic>Humans</topic><topic>Inpatient care</topic><topic>Intervention</topic><topic>Length of Stay</topic><topic>Long-Term Care - standards</topic><topic>low fat foods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Middle Aged</topic><topic>nutrient requirements</topic><topic>Nutrition</topic><topic>Nutrition Assessment</topic><topic>nutrition education</topic><topic>nutritional adequacy</topic><topic>nutritional intervention</topic><topic>patient care</topic><topic>Patient Care Team</topic><topic>patients</topic><topic>Physician's Role</topic><topic>Practice Guidelines as Topic</topic><topic>Professional Autonomy</topic><topic>Quality of Health Care</topic><topic>Retrospective Studies</topic><topic>school food service</topic><topic>school lunch</topic><topic>Serum Albumin - analysis</topic><topic>socioeconomic status</topic><topic>Treatment Outcome</topic><topic>tube feeding</topic><topic>Weight Gain</topic><topic>Whites</topic><toplevel>online_resources</toplevel><creatorcontrib>Braga, Jennifer M.</creatorcontrib><creatorcontrib>Hunt, Alice</creatorcontrib><creatorcontrib>Pope, Janet</creatorcontrib><creatorcontrib>Molaison, Elaine</creatorcontrib><collection>AGRIS</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Dietetic Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Braga, Jennifer M.</au><au>Hunt, Alice</au><au>Pope, Janet</au><au>Molaison, Elaine</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implementation of Dietitian Recommendations for Enteral Nutrition Results in Improved Outcomes</atitle><jtitle>Journal of the American Dietetic Association</jtitle><addtitle>J Am Diet Assoc</addtitle><date>2006-02-01</date><risdate>2006</risdate><volume>106</volume><issue>2</issue><spage>281</spage><epage>284</epage><pages>281-284</pages><issn>0002-8223</issn><issn>2212-2672</issn><eissn>1878-3570</eissn><eissn>2212-2680</eissn><coden>JADAAE</coden><abstract>A primary role of the registered dietitian (RD) is to assess nutritional needs of patients in states of physiological stress and illness and to recommend changes to diet and tube feedings when warranted. However, implementation of changes is dependent upon the physician accepting the recommendations of the RD. This study evaluated outcomes of two groups of enterally fed patients in a long-term acute-care facility in northwest Louisiana: (a) those for whom the physician accepted RD recommendations; and (b) those for whom the physician did not accept RD recommendations. Data showed that physician-prescribed enteral formulas provided 10.0% less kilocalories and 7.8% less protein than the RD-assessed needs.
t tests showed that when RD recommendations were implemented, patients had a significantly shorter length of stay (28.5±1.8 vs 30.5±4.8 days,
P<0.05), as well as significantly improved albumin (0.13±0.17 vs −0.44±0.21 g/dL [1.3±1.7 vs −4.4±2.1 g/L],
P<0.05) and weight gains (0.51±0.1 vs −0.42±0.2%,
P<0.05) when compared to those who continued with physician’s orders. These data suggest that if RDs had the authority to write nutrition orders and provide early nutrition intervention, patient care would improve.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>16442879</pmid><doi>10.1016/j.jada.2005.10.039</doi><tpages>4</tpages></addata></record> |
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| language | eng |
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| source | Elsevier |
| subjects | Adolescent Adult Aged Aged, 80 and over Americans Biological and medical sciences Blacks Clinical outcomes Comparative studies Critical Care Dietary Proteins - administration & dosage dietary recommendations dietetics Dietetics - methods Dietetics - standards Dietitians Energy Intake Enteral Nutrition - standards environment environmental factors Female food choices Food Service, Hospital - standards health promotion healthful Hispanics hospital diet hospitalized adult patients Hospitals, Convalescent - standards Humans Inpatient care Intervention Length of Stay Long-Term Care - standards low fat foods Male Medical sciences Metabolic diseases Middle Aged nutrient requirements Nutrition Nutrition Assessment nutrition education nutritional adequacy nutritional intervention patient care Patient Care Team patients Physician's Role Practice Guidelines as Topic Professional Autonomy Quality of Health Care Retrospective Studies school food service school lunch Serum Albumin - analysis socioeconomic status Treatment Outcome tube feeding Weight Gain Whites |
| title | Implementation of Dietitian Recommendations for Enteral Nutrition Results in Improved Outcomes |
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