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Development, Pilot Testing, and Preliminary Validation of a Parenteral Nutrition Macronutrient Assessment Tool
Andrew E Adorno1, Carol Ireton-Jones2, Mindy A Patterson1
1Department of Nutrition and Food Sciences, Texas Woman's University, Houston, Texas, USA.
Introduction:
Parenteral nutrition is an intravenous form of nutrition support for patients unable to meet nutritional needs through the gastrointestinal tract. While guidelines exist for parenteral nutrition macronutrient prescription, variability in clinical practices highlights the need for an assessment tool to evaluate clinician decision-making. This study aimed to develop, pilot test, and perform preliminary validation of a parenteral nutrition macronutrient assessment tool in a sample of clinicians to evaluate prescribing practices.
Methods:
Eight clinical scenario-based questions were developed and refined through expert testing and feedback. Reliability and validity were assessed with experienced clinicians (n = 7, mean 18.3 years of experience) and early-career clinicians (n = 4, mean 2.8 years of experience) involved in parenteral nutrition prescribing. Test-retest reliability and paired samples t-tests were used for statistical analysis.
Results:
Test-retest reliability was strong (R or rs > 0.7), with dextrose prescribing showing the highest consistency. Questions with lower reliability were refined based on participant feedback, and refinements were assessed descriptively through pilot tester evaluation. Tool favorability ratings improved from 4.3/5 (86%) to 4.9/5 (98%) following revisions.
Conclusions:
The parenteral nutrition macronutrient assessment tool demonstrated preliminary evidence of reliability and content validity in assessing prescribing practices. Refinements enhanced favorability, clarity, and perceived clinical relevance. The survey tool may be useful for identifying practice variability and informing educational interventions to improve parenteral nutrition prescribing. Further evaluation in larger and more diverse clinician populations is warranted.
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