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Winderlich J, Little B, Oberender F, Farrell T, Jenkins S, Landorf E, Menzies J, O'Brien K, Rowe C, Sim K, van der Wilk M, Woodgate J, Udy AA, Ridley EJ. Dietitian and nutrition-related practices and resources in Australian and New Zealand PICUs: A clinician survey. Aust Crit Care 2024; 37:490-494. [PMID: 37169654 DOI: 10.1016/j.aucc.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/19/2023] [Accepted: 03/14/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Recommendations to facilitate evidence-based nutrition provision for critically ill children exist and indicate the importance of nutrition in this population. Despite these recommendations, it is currently unknown how well Australian and New Zealand (ANZ) paediatric intensive care units (PICUs) are equipped to provide nutrition care. OBJECTIVES The objectives of this project were to describe the dietitian and nutrition-related practices and resources in ANZ PICUs. METHODS A clinician survey was completed as a component of an observational study across nine ANZ PICUs in June 2021. The online survey comprised 31 questions. Data points included reporting on dietetics resourcing, local feeding-related guidelines and algorithms, nutrition screening and assessment practices, anthropometry practices, and indirect calorimetry (IC) device availability and local technical expertise. Data are presented as frequency (%), mean (standard deviation), or median (interquartile range). RESULTS Survey responses were received from all nine participating sites. Dietetics staffing per available PICU bed ranged from 0.01 to 0.07 full-time equivalent (median: 0.03 [interquartile range: 0.02-0.04]). Nutrition screening was established in three (33%) units, all of which used the Paediatric Nutrition Screening Tool. Dietitians consulted all appropriate patients (or where capacity allowed) in six (66%) units and on a request or referral basis only in three (33%) units. All units possessed a local feeding guideline or algorithm. An IC device was available in two (22%) PICUs and was used in one of these units. CONCLUSIONS This is the first study to describe the dietitian and nutrition-related practices and resources of ANZ PICUs. Areas for potential improvement include dietetics full-time equivalent, routine nutrition assessment, and access to IC.
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Affiliation(s)
- Jacinta Winderlich
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Department of Epidemiology and Preventative Medicine, Monash, University, Melbourne, VIC, Australia; Paediatric Intensive Care Unit, Monash Children's Hospital, Melbourne, VIC, Australia.
| | - Bridget Little
- Starship Child Health, Auckland City Hospital, Auckland, New Zealand
| | - Felix Oberender
- Paediatric Intensive Care Unit, Monash Children's Hospital, Melbourne, VIC, Australia
| | - Tamara Farrell
- Nutrition & Dietetics Department, Perth Children's Hospital, Perth, WA, Australia
| | - Samantha Jenkins
- Nutrition and Dietetics, John Hunter Children's Hospital, New Lambton Heights, NSW, Australia
| | - Emma Landorf
- Nutrition Department, Women's & Children's Hospital, Adelaide, SA, Australia; Nutrition Department, Alfred Health, Melbourne, VIC, Australia
| | - Jessica Menzies
- Nutrition and Dietetics, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Katie O'Brien
- Department of Nutrition & Food Services, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Carla Rowe
- Nutrition & Dietetics, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Kirsten Sim
- Nutrition & Dietetics, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Melanie van der Wilk
- Nutrition & Dietetics Department, Perth Children's Hospital, Perth, WA, Australia
| | - Jemma Woodgate
- Department of Dietetics & Foodservices, Children's Health Queensland Hospital, Brisbane, QLD, Australia
| | - Andrew A Udy
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Department of Epidemiology and Preventative Medicine, Monash, University, Melbourne, VIC, Australia; Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, VIC, Australia
| | - Emma J Ridley
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Department of Epidemiology and Preventative Medicine, Monash, University, Melbourne, VIC, Australia; Nutrition Department, Alfred Health, Melbourne, VIC, Australia
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