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Nutritional follow-up in children after discharge: Organisation in a tertiary care centre
Marissa Kooij1, Emma Koster1, Renate Eveleens2
1Erasmus Medical Centre Sophia Children's Hospital, Rotterdam, The Netherlands.
Insights
Nutritional interventions are common in pediatric patients, but follow-up care after hospital discharge is inconsistent. Improved multidisciplinary communication and documentation are needed for better nutritional support.
Area of Science:
- Pediatric Nutrition
- Healthcare Management
- Clinical Dietetics
Background:
- Nutritional interventions are frequently administered to pediatric patients.
- The organization of nutritional follow-up (FU) post-discharge requires evaluation to improve patient care standards.
Purpose of the Study:
- To assess the organization of nutritional follow-up (FU) for pediatric patients at hospital discharge and 6 months post-discharge.
- To identify gaps in nutritional care and reporting.
Main Methods:
- Retrospective chart review of 206 pediatric patients admitted to a tertiary hospital.
- Data collected included demographics, anthropometrics, nutritional interventions, and involved healthcare providers (HCPs).
- Nutritional care FU was categorized by care setting (primary, secondary, tertiary).
Main Results:
- 58% of patients received nutritional intervention pre-hospitalization, increasing to 74% at discharge.
- Only 38.8% received nutritional care FU, involving 114 HCPs, with dietitians comprising 53.5%.
- Discharge letters rarely contained complete nutritional intervention reports (20.3%); weight standard deviation scores increased significantly by 6 months FU.
Conclusions:
- A substantial number of pediatric patients require nutritional interventions.
- Nutritional care is fragmented across various HCPs, often lacking multidisciplinary coordination.
- Inconsistent and incomplete reporting of nutritional care in discharge summaries hinders continuity of care.
Background:
Aiming to improve the standard of care for patients with a nutritional intervention, we evaluated how nutritional follow-up (FU) is organised at discharge and after 6 months.
Methods:
From 16 November 2020 until 20 December 2020, we retrospectively included patients admitted for > 1 day to the general ward of a tertiary hospital. Medical charts were reviewed for demographics, anthropometric measurements and nutritional interventions (e.g., tube, parenteral nutrition). Involved healthcare provider (HCP), dietitian and speech and language therapist (SLT) were scored. Nutritional care FU was categorised as in a primary, secondary or tertiary care setting.
Results:
We included 206 (52.4% male) patients, with a median length of stay of 4 (3-8) days. Prehospitalisation 58 (28.2%) patients had a nutritional intervention compared to 74 (35.9%) patients at discharge. In total, 80 (38.8%) patients received nutritional care FU by a total of 114 HCP, and approximately half (53.5%) were dietitians. FU was mostly conducted by a dietitian in the tertiary care (78.7%) and by an SLT in the primary care (54.5%). For 15 (20.3%) patients, the discharge letter included complete reports of nutritional interventions. At 6 months FU, 26.6% of the children still had a nutritional intervention. Mean weight standard deviation score increased significantly between discharge from the hospital and 6 months FU.
Conclusions:
A considerable amount of paediatric patients received a nutritional intervention pre- and post-hospitalisation. Nutritional care is organised around a multitude of different HCP; however, not all cases are multidisciplinary. Nutritional care was scarcely reported correctly in the discharge letter.
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