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

Abstract

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)

Nutrition therapy in the intensive care unit during the COVID-19 pandemic: Findings from the ISIIC point prevalence study

“…However, previous observational studies including worldwide surveys [6,7] showed that nutrition targets, especially for protein, were often never achieved and with a number of barriers limiting adequate nutrition therapy [8,9]. Some approaches related to ICU administrative structures, such as dietitian participation [10] or nutrition protocols [11], may contribute to achieving nutrition targets.…”

Barriers to Delivery of Enteral Nutrition in Intensive Care Settings in Saudi Arabia: A Comparative Study of the Perceptions of Health Care Providers Working in Adult and Paediatric ICUs

“…Many studies have emphasised the role of the dietician in managing and minimising malnutrition in hospitalised patients, reducing the incidence of underfeeding, and improving the overall outcomes. [25][26][27] Furthermore, research has shown that the availability of dedicated registered dietitians in ICUs improves the compliance to EN orders and substantially improves protein delivery to critically ill patients. 26 Overall, these findings highlight the role of the multidisciplinary team in improving nutrition delivery in intensive care settings.…”

Mudanças da atuação multiprofissional em pacientes com COVID-19 em unidades de terapia intensiva

“…No contexto hospitalar, especificamente em UTI, o nutricionista atua de modo a ofertar uma melhor assistência nutricional ao paciente, através de avaliação do estado nutricional; elaboração de prescrição dietética e identificação das intercorrências relacionadas à terapia nutricional, realizando o acompanhamento da evolução nutricional do paciente. As intervenções nutricionais individualizadas e precoces estão ligadas à diminuição do tempo de internação hospitalar, aumento da oferta calórico-proteica, diminuição da mortalidade e melhoria da qualidade de vida após a alta (17,40) .…”