Consistency of Australian and New Zealand dietitians' identification of refeeding syndrome risk and comparison with refeeding guidelines and patient electrolytes and supplementation treatment

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Limited research exists on how consistently dietitians are identifying refeeding syndrome risk in hospitalised patients. We aimed to describe how consistent Australian and New Zealand dietitians are at identifying refeeding syndrome risk and compare their responses to the application of refeeding syndrome guidelines and patients' electrolyte levels and supplementation provided.


Dietitians from Australia and New Zealand were invited to complete an online survey. The survey inquired about demographics and asked respondents to classify the level of refeeding syndrome risk (i.e. none, some, high) in 13 case studies. Electrolytes and supplementation data were sourced from electronic patient records. Descriptive statistics and t-tests were conducted.


Two hundred and ninety-nine eligible people responded (33 ± 9 years, 95%F, 48% had ≥7 years of dietetic experience, 91% working clinically, 87% Australian). Respondents' answers were generally consistent and dietitians often reported the same level of refeeding syndrome risk as the application of NICE guidelines and patient electrolytes (49–98%). Respondents requested feedback on their responses, more detailed case information, and commented on factors that may influence their risk identification, including subsequent medical management and route of nutritional delivery.


Dietitians were generally consistent in the identification of refeeding syndrome risk. Dietitians often reported similar levels of refeeding syndrome risk to those found with the application of refeeding guidelines and patient electrolytes and supplementation treatment. Evaluation of practice was valued by dietitians. Enhancing the evidence on which guidelines are based may improve translatability of guidelines to practice.

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