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Dietitians

Nutrition Assessment and Reassessment

The Dietitians complete an initial assessment of patients within one day of receipt of consult/referral.The assessment is based on a comprehensive review of the medical record, laboratory data, nutrition status, and fluid status.Imaging reports (e.g. KUB, chest x-ray) will be reviewed to verify EN and/or PN access (consistent with LLUMC policies R-33 and R-15).Recommendations for EN and/or PN will be provided and communicated with the primary service.

The Dietitians complete a reassessment at minimum every four to five days to assess tolerance of the prescribed nutrition regimen and provide recommendations for modifications as needed.

Policy

  • M-107C: Assessment and Reassessment of Patients: Dietitians

Enteral Nutrition

Enteral Nutrition (EN) is provided to patients with a functional GI tract to either supplement inadequate oral intake or as the sole source of nutrition.  EN is administered via gastric feeding tube (e.g. OGT/NGT, PEG, G-tube) or small bowel feeding tube (e.g. ND/NJ, PEJ, J-tube).

How to Order an Enteral Nutrition Consult

  • Go to Manage Orders
  • Search for “tube feed”
  • Select  Adult TPN/Enteral Nutrition Consult
  • Select  Enteral Nutrition Evaluation
  • Click Accept

Home Enteral Nutrition Set-up

Patients to be discharged home with EN will be transitioned from an inpatient nutrition regimen to an outpatient regimen.  Continuous EN will be modified to bolus feeds (if gastric access available) or cyclic/NOC feeds (if pump feeds required).  Additional fluid to maintain hydration post discharge will be recommended as needed.

Enteral Formula Manufacturers (on LLU Enteral Formulary)

*Please note only select products available for inpatient use

Policies

  • R-33: Enteral Nutrition for Adult Patients
  • R-42: Enteral/Oral Supplement Formulary Substitutions

Parenteral Nutrition

Parenteral Nutrition (PN) is provided to patients with a non-functional and/or non-accessible GI tract via a peripheral or central venous access device (e.g. PICC, Broviac, Hickman). PN is not administered via midline catheter.

How to Order a Parenteral Nutrition Consult

  • Go to Manage Orders
  • Search for "TPN"
  • Select Adult TPN/Enteral Nutrition Consult
  • Select Parenteral Nutrition Evaluation
  • Click Accept

Home Parenteral Nutrition Set-up

Patients to be discharged home with PN will be transitioned from an inpatient nutrition regimen to an outpatient regimen.  PN will be modified to a cyclic (<24 hours/day) infusion prior to discharge. Additional fluid to maintain hydration post discharge will be recommended as needed.

Policy

  • R-15: Parenteral Nutrition (PN)

Outpatient Nutrition Support Clinic

Patients who are currently receiving EN and/or PN may be referred to the Outpatient Nutrition Support Clinic by their Physician. A Dietitian will meet with the patient to review nutrition status and nutrition regimen (diet/EN/PN/fluids). Recommendations for diet/ EN/PN/fluid modifications will be provided to the referring Physician.

Resources

Additional Information

Nutrition Services One Portal page

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