Nutrition plays an important role in maintaining health, yet many hospitalized patients have subsisted on less-than-optimal nutrient intake for prolonged periods, which can contribute to poor outcomes.
“Malnutrition is associated with high morbidity and mortality, longer hospital stays and increased costs,” said Dawn W. Adams, M.D., associate professor of medicine and director of the Center for Human Nutrition at Vanderbilt University Medical Center.
“By providing nutritional support during the hospital stay, it is possible to mitigate some of these adverse outcomes.”
Adams and her nutrition-support team – who care for patients with compromised nutritional status – have been recognized for excellence by the American Society for Parenteral and Enteral Nutrition (ASPEN) by being named a Clinical Nutrition Team of Distinction.
The award indicates that the unit complies ASPEN’s national standards, guidelines and values and provides the highest level of care to patients.
“Nutritional support teams are not available at every hospital,” Adams said. “Some hospitals recognize the value of addressing malnutrition, understanding its impact on clinical outcomes and cost savings.”
Nutritional Support Necessary
According to Adams, recognizing nutritional risk and starting custom nutrition therapy quickly are steps vital optimal health outcomes and cost effectiveness for hospitalized patients.
She said her nutrition-support team stands out for its multidisciplinary nature and focus on interactions with primary care teams, which Adams describes as unique.
“We have created a unique environment that upholds excellence in clinical care.”
“We make it a point to be proactive in our communication with the primary teams to ensure that our nutrition plans are not just for the present day but are also thought-out for the upcoming week or month,” Adams explained.
The nutrition team includes doctors, nurses, registered dietitians and pharmacists, all of whom have undergone specialized training in nutritional health. Adams notes that several team members are recognized as leaders in the field on a national level.
“With a strong passion for education, our team is actively engaged in various initiatives to train and educate future generations,” Adams said.
She encourages clinicians who are interested nutrition education to begin with small steps, like mentoring interns or training fellows. Expertise will grow from there.
Ensuring Safety in Transitions
Vanderbilt’s nutrition-support team also is involved in clinical trials. Team members are especially interested in research surrounding safety and quality improvement. Recently, they investigated the safety of parenteral nutrition orders for non-digestive tract nutrition and uncovered a high error rate for patients transitioning from one care site to another, such as hospital to home.
“There is a need for improved education and training across all disciplines, especially for those without access to multidisciplinary nutrition support.”
“Adverse events are commonly linked to parenteral nutrition safety violations,” Adams said. “There is a need for improved education and training across all disciplines, especially for those without access to multidisciplinary nutrition support.”
Adams and her team plan to continue to evaluate all aspects of parenteral nutrition orders that follow a patient through transfers of care. The long-term goal is to enhance patient safety by reducing errors.
“A variety of factors have resulted in non‐standardized and disorganized management of parenteral nutrition therapy across practice settings,” Adams noted. “We want to set a clear standard for parenteral nutrition and offer guidance on proper management during care transitions.”
Adams believes that working with this exceptional team of colleagues is “a privilege.”
“We have created a unique environment that upholds excellence in clinical care,” she said.
