The role of the dietitian in the intensive care unit

Abstract

The scope of practice of intensive care dietitians defines them as clinicians, educators and researchers. Their skill set is a unique and vital component of the intensivist-led multidisciplinary intensive care unit team.

Nutrition in the intensive care unit

“…Darawad, et al and others also reported that healthcare professionals commonly understand the significance of nutrition in managing patients, but their knowledge is inadequate. 13,16,17 Even in hospitals with competent staff and trained professionals, nutritional support was sporadic and hampered by inconsistency and miscommunication.…”

“…One tool often utilized in this calculation is indirect calorimetry. 13,15 Even with this tool, it is challenging to determine the exact caloric needs of each patient.…”

“…This team approach can improve patient outcomes and reduce overall costs. 10,13,24 A study at Albert Einstein Medical Center reports that the use of NT specialists could reduce preventable costs by as much as $156,654 per year. 24 Likewise, the presence of educated NT team correlated with patients receiving more EN (6.7 vs. 5.4 per 10 patient-days) and reduced overall LOS (25 v 35 days).…”

“…Most medical train-ing programs in the US have limited exposure to nutrition education, and studies have shown a notable discordance between nutrition knowledge and application among physicians, fellows, and residents. 8,[10][11][12][13] This disunity in nutrition management in medical professionals is worrisome and identifies an opportunity to improve outcomes through education.…”

American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and American Dietetic Association (ADA): Standards of Practice and Standards of Professional Performance for Registered Dietitians (Generalist, Specialty, and Advanced) in Nutrition Support

“…3 This interdisciplinary team approach has been shown to reduce cost and improve patient outcomes, and the RD is a key resource in various aspects of nutrition support therapy, including determinations of route and timing. 23 Skipper 24 suggests that the dietetics profession consider the model of the profession of advanced practice nursing, which is a definitive model for progressive clinical practice. For the advanced level practice RD in nutrition support, this model could include activities such as management of insulin therapy, catheter and device care, etc.…”