This issue of Topics in Clinical Nutrition provides a collection of articles related to various aspects of clinical nutrition and practice. An exploration of dietetics practice includes an evaluation of dietitians' preferences for digital learning format, an appraisal of dietetic preceptors' knowledge, skills, and attitudes (KSAs), an examination of evidence-based dietetics practice (EBDP), and identification of commonly used nutrition diagnoses (NDs) in acute care. Additional topics include nutrition and dysphagia screening, the role of health literacy in management of type 1 diabetes mellitus (T1DM), as well as 2 articles describing nutrition in the critically ill.
Chan et al conducted a cross-sectional study evaluating the learning preferences and YouTube usage for nutrition education of 185 members of the Dietitians in Nutrition Support practice group. In-person education and videos were the most preferred methods for learning, with younger dietitians preferring audio and video learning and older dietitians preferring written or live digital presentations. Barriers related to using educational videos include lack of relevant content and difficulty identifying valid resources.
Benoit, Shreim, and Andrade evaluated the KSAs of US dietetic preceptors through a mixed-methods research study in which 141 participants completed a quantitative survey. The KSAs of the participants were found to be high (4.5/5). The qualitative feedback identified that preceptors desired further training in communication, teaching, and evaluation through an online or webinar format. The findings identify the need for tailored preceptor training materials to support dietetics training.
Van Horn and Wright of the University of North Florida examined the relationship between the use of EBDP by education level and years of experience through a qualitative study of 9 dietitians. The themes of resources, utilization, barriers, and collaboration were identified. While master's trained dietitians were found to be more knowledgeable of EBDP resources, recency of education was also associated with greater confidence in EBDP skills.
Hakel-Smith and Ritter-Gooder sought to identify the most frequently used NDs in acute care practice through a descriptive research study of 7 dietitians. Nineteen of 84 NDs (23%) were identified as prevalent. Content validation of the 19 NDs showed 24% of characteristics as critical, with the highest ranking NDs focused on macronutrient deficiency, a top concern for acute care patients. Although this pilot study had a small sample size and limited generalizability, it offers a framework for describing NDs in a specific practice area.
Garipoglu et al conducted a study of 187 adult patients who were screened with the NRS (Nutrition Risk Screen) 2002 tool to evaluate nutritional status and the EAT-10 (Eating Assessment Tool) tool to screen for dysphagia risk. A statistically significant correlation was found between a high EAT-10 score and a high initial and final NRS score, indicating that patients who had a high malnutrition risk had a higher rate of dysphagia while those with dysphagia had a high malnutrition risk. The findings highlight the importance of routine malnutrition and dysphagia screening to minimize adverse hospital outcomes.
Gumus et al conducted a study of 120 Turkish adolescents with TIDM and 190 Turkish adolescents without TIDM to establish validity and reliability of the Newest Vital Sign (NVS) as well as to evaluate their health literacy with age, gender, and health status. The NVS was found to be a valid measurement tool in Turkish adolescents. Adolescents with T1DM were found to have limited health literacy and mean HbA1c decreased with improved health literacy, indicating that addressing health literacy may contribute to improved T1DM management in this population.
Blakeslee et al of Maine Medical Center investigated bowel dysfunction, including diarrhea and constipation, and its association with enteral nutrition (EN) and medication in 4118 critically ill patients through a retrospective study. They found that 68% of patients had diarrhea while 8% had constipation, with both conditions more prevalent in the EN group. Patients on EN received more medications but had a lower incidence of diarrhea than those who did not receive EN. These findings highlight the importance of considering the multifactorial causes of bowel dysfunction in the critically ill.
Wedemire, Radler, and Zelig from Rutgers University conducted a narrative review of clinical outcomes of critically ill patients with and without low muscle mass upon admission to the intensive care unit. They identified a statistically significant association between low muscle mass and increased mortality and length of stay, highlighting the importance of screening for low muscle mass as a nutrition risk indicator to improve clinical outcomes.
Thank you for your support of Topics in Clinical Nutrition. We are open to suggestions for topics and areas of interest to highlight in future editions of the journal.
-Kelly Kane, MS, RD, CNSC
Editor
Topics in Clinical Nutrition