PhilSPEN Online Journal of Parenteral and Enteral Nutrition

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(Article 103 | POJ_0096)

Submitted Abstracts

PENSA 2017 Congress

Submitted: August 13, 2017

Abstract ID = 66 | Classification: (7) - Nutrition team including nutrition care process

Title: Nutrition prescription concerns in hospital charts: recognizing the benefits of a nutrition intervention team

Author(s): Alicia Mitra, RND (1); Anna Mae P. Cinco, RND (2); Cassandra Bigornia, RND (3); Naheeda D. Mustofa, MD FPCP DPBCN (4)

Institution where study was conducted:

    1. Head Dietitian, Dietary Department
    2. Clinical Dietitian
    3. Therapeutic Dietitian
    4. Program Head, Nutrition Intervention Management Service, Perpetual Help Medical Center-BiƱan

Keywords: nutrition prescription, calorie, protein, fat, tube feeding, formulas

Background: Dietitians are the key players in nutrition counseling and quality food and enteral tube feeding delivery while supposedly complying with prescriptions ordered by physicians in hospital charts. Clinical nutrition, however, is offered as a subspecialty and is not yet taught as a separate subject in the medical curriculum, reason why most resident physicians-in-training would need to undergo training orientations for better patient care. Physician-dietitian interaction is also not commonplace in hospital rounds.

Objectives: The study aims to identify chart nutrition prescription problems in this training institution to assist in hospital policy-making for its newly established nutrition intervention team.

Methods: A retrospective review of nutrition prescriptions by physicians was done using the Dietary department database between June and July 2017. The study was conducted in a tertiary training hospital in South Luzon, Philippines.

Results: A total of 1038 patients were admitted during the study period. Common prescription concerns encountered were as follows: Total Caloric Requirement (TCR) does not tally with specified grams of CHO, CHON and Fat (n=56 or 5.4%); unspecified tube feeding dilution (n=45 or 4.3%); confusing diet modifications without TCR specifications (i.e “full diet, low protein 40 grams”) (n=2); confusing requirements between TCR and Total caloric intake (TCI) (n=1); and an overshoot in caloric and protein requirement from modular and calorie-dense formulas due to lack of formula familiarization (n=1).

Conclusion: Nutrition prescription concerns still exist in the workplace. Utilization of a nutrition intervention service is needed to enhance physician-dietitian communication.