Enteral nutrition practices: similarities and differences between dietitians and physicians in Connecticut

There has been little evaluation of attitudes, beliefs, and practices of health professionals involved in the provision of enteral nutrition support. A study was undertaken to define and describe enteral feeding practices of registered dietitians (R.D.s) and physicians (M.D.s) in Connecticut. Survey questionnaires were returned by 74.5% of R.D.s and 53.3% of M.D.s. Data were analyzed for 195 respondents. Overall, there were more similarities than differences between R.D.s and M.D.s. Malnutrition was the most frequent indication for tube feedings. Dietitians and physicians selected formulas on the basis of nutrient needs of the patients, but R.D.s gave significantly more weight to formula design and nutrient composition than did M.D.s. Lactose-free low-residue, high-calorie high-nitrogen, and elemental diets were considered to be the most desirable products to include in a hospital formulary. Dietitians more frequently monitored nutrition-related parameters, whereas M.D.s followed metabolic parameters of patients on tube feeding. Physicians relied on R.D.s to recommend formulas and to provide them with enteral nutrition information. The results from this study may be useful in planning nutrition education programs, evaluating standards for enteral nutrition practice, and improving utilization of enteral nutrition therapy.