Moving the issue of renal dietitian staffing forward.
The day-to-day pragmatic work realities of dietitians who cover dialysis clinics are rarely the focus of discussion. This article highlights the points of convergence between these realities and the research literature. Focusing on the National Kidney Foundation Kidney Disease Outcomes Quality Initiative clinical practice guidelines for nutrition and the difficulties encountered with their full implementation, a seemingly pervasive problem of limited time is revealed. Given the evidence that renal dietitians can positively impact morbidity and mortality risks, when protein-energy malnutrition is primarily the byproduct of insufficient nutrient intake, it suggests that progress with enhancing the nutritional status of patients may be fundamentally contingent on increasing the time they have available, through improved staffing.
Women's Institute for Family Health, Philadelphia, Pennsylvania, USA. Wol2will@aol.com
William A
WA
Wolfe
D004046:Dietetics; D019317:Evidence-Based Medicine; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000178:diet therapy* / Q000401:mortality; D009752:Nutritional Status; D010561:Personnel Staffing and Scheduling; D017410:Practice Guidelines as Topic; D011502:Protein-Energy Malnutrition / Q000175:diagnosis / Q000517:prevention & control; D011787:Quality of Health Care; D006435:Renal Dialysis; D016896:Treatment Outcome