Evaluation of an Innovative Method for Calculating Energy Intake of Hospitalized Patients.
The purpose of this study was to evaluate a multi-component method for capturing nutrient intake, which used observation, photography, and an innovative computer program. To assess reliability and accuracy, multiple responsible employees (REs) independently conducted nutrient intake assessments on simulated meals; each RE's results relating to energy intake were compared to those from the other REs and to those obtained by pre- and post-meal weighing of the food items. System efficiency was assessed by having REs perform independent assessments on the same set of simulated meals using either the new or traditional hospital method for which the REs had to document each food item served and then find the items in a computer database-steps that were automated in the new method. Interrater reliability for energy intake estimated on clinic wards was excellent (intraclass correlation coefficient = 0.975, 95% CI 0.958 to 0.992) and there was a high level of agreement between the REs' estimates and the true values determined by food weighing; per the method of Bland and Altman the mean difference between the two types of estimates was 0.3 kcal (95% CI, -8.1 to 8.7 kcal) with limits of agreement of -79.5 kcal to 80.1 kcal. Compared to the traditional method, energy intake assessments could be completed using the multi-component method in less than a third of the time. These results indicate the multi-component method is an accurate, reliable, and efficient method of obtaining energy intake assessments for hospitalized patients.
VISN 16/CAVHS Geriatric Research Education and Clinical Center (GRECC), 2200 Fort Roots Drive, 3J/GRECC, North Little Rock, AR 72114, USA. sheila.sullivan2@va.gov.
Sheila
S
Cox Sullivan
VISN 16/CAVHS Geriatric Research Education and Clinical Center (GRECC), 2200 Fort Roots Drive, 3J/GRECC, North Little Rock, AR 72114, USA. melinda.bopp@va.gov.
Melinda M
MM
Bopp
VISN 16/CAVHS Geriatric Research Education and Clinical Center (GRECC), 2200 Fort Roots Drive, 3J/GRECC, North Little Rock, AR 72114, USA. robersonpaulak@uams.edu.|Department of Biostatistics, College of Medicine; University of Arkansas for Medical Sciences, 4301 W. Markham St. #781, Little Rock, AR 72205, USA. robersonpaulak@uams.edu.
Paula K
PK
Roberson
VISN 16/CAVHS Geriatric Research Education and Clinical Center (GRECC), 2200 Fort Roots Drive, 3J/GRECC, North Little Rock, AR 72114, USA. Shelly.Lensing@va.gov.|Department of Biostatistics, College of Medicine; University of Arkansas for Medical Sciences, 4301 W. Markham St. #781, Little Rock, AR 72205, USA. Shelly.Lensing@va.gov.
Shelly
S
Lensing
VISN 16/CAVHS Geriatric Research Education and Clinical Center (GRECC), 2200 Fort Roots Drive, 3J/GRECC, North Little Rock, AR 72114, USA. dennis.sullivan3@va.gov.|Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. dennis.sullivan3@va.gov.
Dennis H
DH
Sullivan
D004032:Diet; D015930:Diet Records; D002149:Energy Intake; D005521:Food Service, Hospital; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D062407:Meals; D015596:Nutrition Assessment; D010781:Photography; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
diet; nutrition assessment; nutrition status; nutritional deficiency; undernutrition