Acute Nutrition Interventions Help Identify Indicators of Quality in a Trauma Service

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Clinical indicators of nutrition care are needed to help improve patient outcomes. To identify potential indicators of nutrition care, 1 dietitian in a trauma service prospectively documented every immediate action she undertook to prevent or correct an adverse, nutrition-related outcome. A total of 101 acute nutrition interventions were provided with 93 (5.2%) of the 1777 nutrition evaluations conducted over the 10-month period. Patient overfeeding triggered 1 of every 3.5 acute nutrition interventions. Most instances of overfeeding were linked to the lack of an interdisciplinary plan of nutrition care. This was troubling because of the severity of illness among the overfed patients (25% mortality). Other categories that necessitated acute intervention included electrolyte imbalance and underfeeding. Several nutritional problems identified by this study are appropriate for use as rate-based and sentinel event indicators to improve the quality of nutrition care.

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