Which Patients See a Dietitian in a Hospital?

Monongalia General Hospital is an 189 bed acute-care community hospital and level 4 West Virginia trauma center.  With only 2 FTE clinical dietitians working each day, it’s impossible (and unnecessary) for a dietitian to visit every patient in the hospital. But who gets to the see a dietitian, and how is that decided? While it may be different at other hospitals, this is the consult system Mon Gen uses:

1- A physician or nurse orders a consult.  This could be because the physician feels the patient needs nutrition education, the patient is high-risk, or any reason they see fit.

2- A system consult is automatically ordered.  On a patient’s chart, there is a section with several boxes of criteria. If one or more of these criteria is met, the charting system automatically orders a consult. The criteria include unintentional weight loss of more than 10 pounds in 3 months, constipation, bed sores, and more.

3- The patient meets nutrition screening criteria. Dietitians can see patients that meet a specific diagnosis and/or treatment with component of nutrition therapy, including but not limited to:

  • Malnutrition, cancer, undergoing chemotherapy, radiotherapy, major surgery, oncology unit patient
  • Newly diagnosed diabetes mellitus, or uncontrolled
  • Unstable chronic renal disease
  • Unstable liver disease
  • GI: Crohn’s disease, ulcerative colitis, short bowel syndrome, GI fistula, small bowel obstruction
  • Failure to thrive
  • CVA (cerebrovascular accident or stroke) with severe dysphagia
  • Significant education needs

When these methods of ordering a consult with a dietitian are used, clinical dietitians are able to use their time wisely to see the patients who need the most help.

You ordered a consult??

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Categories: Clinical Nutrition | Tags: , , , , , , , , , , , | 3 Comments

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3 thoughts on “Which Patients See a Dietitian in a Hospital?

  1. Deb T

    Yes! I ordered a consult ! Do you make house calls? Lookin’ good, my favorite registered dietician-to-be! So, what does one do for, say, a 6 month old failure to thrive?

    • Provide the infant with a high-kcal diet. If the infant is unable to meet their nutritional needs orally, or the infant is growing at a suboptimal rate, then enteral feeds should be initiated to provide supplemental nutrition. This could be a nasogastric, PEG, or gastrostomy tube feeding, and the formula should be based on the infant’s nutritional needs. Weight & length should be taken weekly to monitor progress, until consistent weight gain is established. Intervention should begin ASAP to prevent any nutritional deficiences from occuring/becoming worse.

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