A standardized system for assessment and delivery of nutrition support in a large teaching hospital.
The nutrition support service (NSS) is consulted to evaluate and provide nutrition support to 500 patients per year. To facilitate this process, three forms--a consultation request form and preprinted parenteral and enteral nutrition order forms are used. The NSS Consult Request form was developed to provide consistency in medical, dietetic, nursing, and pharmacy patient assessments. This form is organized so that it includes clinical information necessary for nutrition assessment. Specifically, the NSS completes a nutrition assessment that includes a diet history; indirect calorimetry, only when indicated; a laboratory (metabolic) assessment; a clinical impression used to put the above-mentioned information into a nutrition perspective; and recommendations for either enteral or parenteral therapy. The recommendation for implementing nutrition support as either total enteral nutrition or total parenteral nutrition is made by using the respective order forms for enteral or parenteral nutrition. These include orders for specific formulas and additives and orders for laboratory monitors, nursing care, and criteria for notification of the physician. These forms facilitate the accurate transcription, preparation, and delivery of NSS orders by pharmacy, dietetics, and nursing departments. This approach provides an excellent framework in which to teach dietitians, pharmacists, nurses, and physicians a method for the delivery of appropriate nutrition support and provides a database for the performance of quality assurance analysis and clinical research.
Cicci
A
A
Sunyecz
L A
LA
Mirtallo
J
J
Flancbaum
L J
LJ
D004750:Enteral Nutrition / Q000379:methods*; D005568:Forms and Records Control; D006784:Hospitals, Teaching; D006801:Humans; D008499:Medical Records; D015596:Nutrition Assessment; D010289:Parenteral Nutrition, Total / Q000379:methods*; D010347:Patient Care Planning; D012017:Referral and Consultation