Assessing the current landscape of North American pediatric nutrition support teams: A survey study.

INTRODUCTION

Nutrition support teams (NSTs) were developed to standardize nutrition evaluation practices and coordinate transdisciplinary expertise for appropriate administration of inpatient nutritional care. Minimal data are available regarding the current practices, structure, and perceived utility of pediatric NSTs in diverse hospital systems.

METHODS

This was a cross-sectional survey study disseminated electronically to three electronic listservs associated with the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN).

RESULTS

Forty-seven unique responses were obtained. Sixty-two percent reported a current NST at their institution. Of those with an NST, 97% reported reviewing parenteral nutrition (PN) orders, 90% recommended nutritional assessment modalities, 86% determined PN appropriateness, and 72% reviewed enteral nutrition orders. More than 50% of respondents strongly agreed that an NST improved patient safety, improved patient nutritional status, improved quality of care, decreased rates of malnutrition, and promoted interdisciplinary care. Among those without an NST, 33% of respondents reported that they were previously unsuccessful at developing an NST at their site. Perceived barriers to NST implementation in more than 50% of respondents were lack of protected time, budget or funding issues, lack of available staff, and lack of interdisciplinary support.

DISCUSSION: This study demonstrates heterogeneity of pediatric NSTs in North America with regard to frequency of services, while showing general consistency in the scope of services provided. It highlights the overall perceived benefit of NSTs. Financial compensation continues to be a barrier to access to NSTs with a notable percentage of NSTs reportedly not billing for services.