Impact of the clinical nutritionist on tube feeding administration

An analysis was conducted to evaluate the effect of nutrition assessment by a registered dietitian on tube feeding (TF) tolerance and the length of time required to meet patients' nutritional requirements via those TFs. All adult patients (no. = 87) receiving TFs at the University of Michigan Medical Center over a 3-month period were studied. Their charts were examined for a nutrition assessment with recommendations for TF delivery rate and formula selection, physician's compliance with those recommendations, and TF tolerance. TF tolerance was defined as the absence of diarrhea, gastric distention, elevated TF residuals, nausea, or vomiting. Patients whose physician followed the recommendation in the registered dietitian's assessment showed a statistically significant benefit in tolerance of the TF in comparison with those patients who received no assessment or those whose physician ignored the recommendation (p less than .05, chi-square test). Average time to meet nutritional requirements via TF was 4 days in patients with nutrition recommendations incorporated into their care vs. 7 in those patients without nutrition assessments. Our results suggest the importance of TF recommendations by the registered dietitian and the practical benefit to the patients when these suggestions are implemented.