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Nutrition in Clinical Practice
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A Comprehensive Pediatric Inpatient Nutrition Support Package: A Multi-disciplinary Approach

Kevin M. Creamer, MD, FAAP

Department of Pediatrics, Tripler Army Medical Center, Hawaii

Debora Schotic Chan, FASHPt

Department of Pharmacy, Tripler Army Medical Center, Hawaii

Christine Sutton, RD, CNSD

Department of Nutrition Support Service, Tripler Army Medical Center, Hawaii

Carmen DeLeon, RN

Department of Nursing, Tripler Army Medical Center, Hawaii

Carol Moreno, BSN, MS

Department of Nursing, Tripler Army Medical Center, Hawaii

B. Alan Shoupe, MD, FAAP

Department of Pediatrics, Tripler Army Medical Center, Hawaii

Objective: To develop an easy-to-use system for initiating and monitoring enteral and parenteral nutrition support for pediatric inpatients. Design: A multidisciplinary pediatric nutrition support team developed a system to deliver appropriate nutrition support to pediatric inpatients. The package was devised and implemented to improve timeliness, safety, and efficacy of pediatric inpatient nutrition support. The goals included an easy to complete nutrition assessment, a system for early appropriate initiation of nutrition, advancement toward projected goal calories, and monitoring parameters for improved outcomes. Results The comprehensive evidence based package consisted of a four-sided laminated pocket reference with flow charts and tables; concise enteral and parenteral clinical nutrition support pathways; and computerized parenteral nutrition order form, a lab order set, and four one-page information sheets for initiation and advancement of age specific parenteral nutrition. A lecture summarizing this manuscript with handouts and bibliography heightened awareness in each department primarily responsible for the care for pediatric patients (Pediatrics, Family Practice, and Surgery) in our hospital. Conclusion: This package is a comprehensive educational tool for our housestaff. We believe it increases the likelihood of appropriate nutrition assessment and delivery by physicians working with pediatric inpatients at our hospital. It is easily adaptable to fit the needs of any inpatient pediatric nutrition support practice setting.

Nutrition in Clinical Practice, Vol. 16, No. 4, 246-257 (2001)
DOI: 10.1177/088453360101600409
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