Implementation of a Multidisciplinary Team That Includes a Registered Dietitian in a Neonatal Intensive Care Unit Improved Nutrition Outcomes

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Abstract

This study determined whether nutrition outcomes of neonates who were receiving neonatal intensive care were improved with the implementation of a fully functioning multidisciplinary team that included a registered dietitian. A medical record review was conducted of neonates with birth weights of 1500 g or less who were cared for in Sanford Children's Hospital neonatal intensive care unit from January 1 to December 31, 2001 (prior to functioning multidisciplinary team establishment) and January 1 to December 31, 2004 (subsequent to establishment of a multidisciplinary team). Data from charts in the 2 time periods were examined for differences in nutrition outcomes. Outcome variables included length of stay, birth weight, discharge weight, weight gained for specified time periods, weight at full feeds, weight gain per day, length, head circumference, and number of days to start enteral feeding. Analysis of covariance, controlling for the effect of birth weight, was used to determine differences and was considered significant at P < .05. The mean length of stay (65 days, 95% confidence interval [CI]: 48–68 vs 72 days, 95% CI: 53–73) was not different for the 2 periods. The mean weight at the beginning of enteral feeding was significantly less in the period prior to the establishment of the multidisciplinary team (1099 g, 95% CI: 955–1165 vs 1164 g, 95% CI: 1067–1211, respectively). Weight at discharge, total weight gained, total daily weight gained, daily weight gain from birth to the initiation of enteral feeds, daily weight gain from birth to full feeds, and head circumference growth were significantly greater for neonates in the postgroup than in the pre-multidisciplinary team group. Implementation of a multidisciplinary team that included a registered dietitian improved the nutrition outcomes of low birth weight infants in a neonatal intensive care unit. (Nutr Clin Pract. 2008;23:630–634)

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