Dietitian Involvement in the Neonatal Intensive Care Unit: More Is Better - 21/08/11
, Douglas K. Richardson, MD, MBA, Christopher H. Schmid, PhD, Lynne M. Ausman, DSc, RD, Johanna T. Dwyer, DSc, RD
Address correspondence to: Irene E. Olsen, PhD, RD, Assistant Professor, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati College of Medicine, Center for Epidemiology & Biostatistics and Division of Neonatology, Cincinnati Children’s Hospital Medical Center (MLC 5041), 3333 Burnet Ave, Cincinnati, OH 45229.Abstract |
Objective |
Describe the level of registered dietitian (RD) involvement in neonatal intensive care units (NICUs) and associations with NICU nutrition practices.
Design |
Questionnaires were mailed to 820 NICUs in the United States with two follow-up mailings to nonresponders. Abbreviated phone surveys were conducted with a random sample of 10% of nonresponders. A nutrition care score was devised based on a sum of 10 survey questions (range 0 to 10) to summarize the intensity of reported practices.
Subjects/Setting |
Directors of NICUs in the United States and RDs associated with them.
Statistical Analyses |
χ2, analysis of variance, Bonferroni and Duncan multiple range tests, regression.
Results |
Respondents from 417 (54%) of the 772 NICUs eligible for the study provided completed questionnaires. Among NICUs responding, 76% involved RDs in care (41% employed full- or part-time RDs, 35% employed consult RDs), and 24% had no RD. NICUs with full- or part-time RDs provided fewer kilocalories and more protein parenterally, and more kilocalories and protein enterally. NICUs with less RD involvement were more likely to provide full-term infant feedings (eg, unfortified breast milk, full-term formula) to very-low-birth-weight infants. Mean nutrition care score varied with RD involvement from 4.6±1.7 (mean±standard deviation) for NICUs with a consult RD and 4.7±1.4 for NICUs employing no RD to 5.6±1.7 for NICUs with a full- or part-time RD (overall P<.001).
Conclusions |
More involvement of RDs in NICUs increased the intensity of important aspects of nutrition care that may improve outcomes of very-low-birth-weight infants in NICUs. These findings highlight the importance of RDs as NICU team members.
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Vol 105 - N° 8
P. 1224-1230 - août 2005 Retour au numéro
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