Diet Order Entry by Registered Dietitians Results in a Reduction in Error Rates and Time Delays Compared with Other Health Professionals

Imfeld, Kristen; Keith, Mary L.; Stoyanoff, Linda; Fletcher, Heather; Miles, Sasha; McLaughlin, Joan E.

doi:10.1016/j.jand.2012.05.020

Cited by 11 publications

(18 citation statements)

References 18 publications

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“…Our study showed that tube-fed stroke patients exhibited a slight increase (mean increase 0.2 kg/m 2 ) in BMI if nutritional monitoring was performed and nutritional plans recommended by dietitians at least once a week were followed. These results are consistent with previous studies [11][12][13]20], and are clinically relevant, because nutritional monitoring and evaluation by dietitians, which is one of the four steps of the nutrition care process, plays a key role in evaluating the efficacy of nutritional intervention, and may prevent weight loss [21]. Activity-related energy expenditure is the most variable form of energy expenditure [22]; moreover, ADLs are positively associated with resting energy expenditure [23].…”

Section: Discussionsupporting

confidence: 89%

Relationship between weight gain, functional recovery and nutrition monitoring in underweight tube-fed stroke patients

Nishioka

Sugawara

Takayama

et al. 2018

Jpn J Compr Rehabil Sci

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Section: Discussionsupporting

confidence: 89%

Relationship between weight gain, functional recovery and nutrition monitoring in underweight tube-fed stroke patients

Nishioka

Sugawara

Takayama

et al. 2018

Jpn J Compr Rehabil Sci

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“…RDs play a major role in nutritional care of patients in the hospital, including inpatient rehabilitation units or facilities (9)(10)(11)(12)15). The present results highlight the potential effectiveness of assignment of RDs on nutritional outcome of patients undergoing rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have shown that RD nutritional recommendations or privileges concerning order-writing by RDs may increase energy intake or decrease erroneous orders (10,11). Similarly, a pilot study demonstrated that nutritional monitoring performed by a RD at least once a week positively impacts on maintenance of body weight in underweight patients after stroke, compared to monitoring just once a month (12).…”

mentioning

confidence: 99%

Assignment of Registered Dietitians and Other Healthcare Professionals Positively Affects Weight Change of Underweight Patients in Convalescent (<i>Kaifukuki</i>) Rehabilitation Wards: A Secondary Analysis of a Nationwide Survey

Nishioka

Kokura

Okamoto

et al. 2019

J Nutr Sci Vitaminol

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This study aimed to verify the relationship between assignment of professional registered dietitians (RDs) and other healthcare professionals and body weight or functional outcome in underweight patients. This was a secondary analysis of the nationwide survey data from Kaifukuki (convalescent) rehabilitation wards (KRWs). Data of patients aged $20 y with disabilities and body mass index (BMI) ,18.5 kg/m 2 and who were discharged from 1,099 KRWs were analyzed. The primary outcome was BMI at discharge. Secondary outcomes were Functional Independence Measure (FIM) at discharge and returning to home. Patients were divided into two groups: those in KRWs with $1 or ,1 dedicated RD per ward (KRW/RD1 and KRW/RD2, respectively). Of 5,843 eligible participants (female, 63%; median age, 82 y; hip/vertebral/knee fracture, 47%; stroke, 34%; disuse syndrome secondary to acute illness, 11%; others, 8%), 1,288 and 4,555 were from the KRW/RD1 and KRW/RD2 groups, respectively. At discharge, KRW/RD1 patients had higher FIM (93 vs. 90) and BMI (17.1 vs. 17.0 kg/m 2) than did KRW/RD2 patients. Multivariable analysis showed that assignment of dedicated RDs (B50.213, 95% confidence interval [CI], 0.036-0.389), number of nurses (B50.023, 95% CI, 0.003-0.043), and daily rehabilitation dose were significantly associated with changes in body weight. Furthermore, these factors positively affected BMI at discharge. Number of nurses and rehabilitation dose correlated with FIM, but assignment of RDs did not correlate with FIM. In conclusion, assignment of RDs, nurses, and sufficient rehabilitation dose may contribute to BMI gain. Nurses and daily rehabilitation dose may positively affect functional recovery.

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“…Registered dietitian nutritionist (RDN) order‐writing privileges can further enhance nutrition care by improving the accuracy and timeliness of nutrition interventions . Early individualized RDN interventions are linked to decreased hospital length of stay, increased calorie and protein delivery, decreased mortality, and improved quality of life post discharge .…”

Section: Introductionmentioning

confidence: 99%

Effect of Registered Dietitian Nutritionist Order‐Writing Privileges on Enteral Nutrition Administration in Selected Intensive Care Units

et al. 2019

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Background: Adequate nutrition is linked to improved patient outcomes during critical illness. Nutrition care is further enhanced by registered dietitian nutritionist (RDN) order-writing privileges, which improve the implementation of nutrition interventions. The purpose of this performance improvement project was to evaluate the effect of RDN order-writing privileges on enteral nutrition (EN) order compliance and nutrition delivery in selected intensive care units (ICUs) at a university-affiliated teaching hospital. Methods: screened for eligibility. Demographic and nutrition data were collected retrospectively from the electronic health record. Percent of energy and protein needs met were calculated. Data were compared with historical internal controls identified prior to RDN order-writing privileges. Results: Fifty adult patients (150 EN days) were included in data analysis, with 93 patients (279 EN days) included in historical data. Compared with historical data, cumulative EN order compliance increased by 17% and tube feed infusion rate compliance by 15% post-RDN order-writing privileges. Mean (± SD) protein needs delivered significantly increased from 72.1 ± 28.6% to 89.1 ± 24.8% after RDN order-writing implementation (P < 0.001). Conclusions: RDN order-writing privileges improved EN order compliance and significantly improved protein delivery in selected ICUs. Future studies are recommended to confirm these results and determine if other variables besides protein delivery are statistically significant with a larger sample size. (Nutr Clin Pract. 2019;34:899-905)

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Diet Order Entry by Registered Dietitians Results in a Reduction in Error Rates and Time Delays Compared with Other Health Professionals

Cited by 11 publications

References 18 publications

Relationship between weight gain, functional recovery and nutrition monitoring in underweight tube-fed stroke patients

Relationship between weight gain, functional recovery and nutrition monitoring in underweight tube-fed stroke patients

Assignment of Registered Dietitians and Other Healthcare Professionals Positively Affects Weight Change of Underweight Patients in Convalescent (<i>Kaifukuki</i>) Rehabilitation Wards: A Secondary Analysis of a Nationwide Survey

Effect of Registered Dietitian Nutritionist Order‐Writing Privileges on Enteral Nutrition Administration in Selected Intensive Care Units

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