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Clinical Observations; Experience of a Clinical Outcome-Based Pediatric Nutrition Support Service

Department of Pharmacy and Clinical Nutrition, Children's Hospital of Buffalo, New York

Nancy Claxton, MS, RD

Department of Pharmacy and Clinical Nutrition, Children's Hospital of Buffalo, New York

Carolyn Manz, BS

Department of Pharmacy and Clinical Nutrition, Children's Hospital of Buffalo, New York

Traci Kelly, BS, RD

Department of Pharmacy and Clinical Nutrition, Children's Hospital of Buffalo, New York

Thomas M. Rossi, MD

Department of Pediatrics, University at Buffalo, New York

ABSTRACT: In an era of reduced health care resources, ongoing documentation of nutrition interventions and resultant clinical outcomes are essential in supporting nutrition support services. Nutrition interventions and clinical outcomes obtained from an ongoing quality-improvement program for a nutrition support service in a tertiary care pediatric hospital is presented. Consecutive cases of inpatients with intermediate- to high-level nutrition risk who were hospitalized from June 1996 through May 1997 were reviewed for standard interventions offered by nutrition support staff members, including recommendations for diet alteration, supplements, TPN, enteral feedings, and nutrition instruction. Of 5369 admissions, 1422 (26.5%) were classified as intermediate-to high-level nutritional risk, requiring 2896 initial and follow-up interventions for which outcome was documented in 1184 cases (83.3%). Improvement was noted more often for cases receiving interventions within 72 hours of admission (91% us. 828%, p = .031) and requiring the least change in behavior or in complex patients. Poor outcome was frequently associated with psychosocial issues. Length of hospitalization was greater for nutritional risk cases (7.2 days) compared with no-risk cases (3.5 days) and was not associated with clinical outcome. Overall, a high rate of improvement in nutritional status was noted and varied with time to intervention and type of intervention. Clinical improvement was not associated with duration of hospitalization for intermediate- to high-level nutritional risk cases. Psychosocial issues were most frequently associated with poor nutritional outcome.

Nutrition in Clinical Practice, Vol. 14, No. 5, 250-253 (1999)
DOI: 10.1177/088453369901400507


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