1. Improving Inpatient Nutrition Education
By Andrea Schmidt
Sodexo Dietetic Intern
Professional Research Project

2. Learning Objectives Examine research on improving nutrition education
Identify effective inpatient nutrition education strategies
Develop a plan to improve St. Anthony’s current nutrition education

3. Diabetic patients receiving clinical nutrition education from a RD versus education from a non-RD health professional see greater improvements in glycemic control?

4. True
In an Indian Health Service Diabetic Care and Outcomes study, participants receiving clinical nutrition education from an RD, or from an RD as well as a non-RD, had the largest improvements in HbA1c levels (􏰁0.26 and 􏰁0.32, respectively) compared with those receiving either only non-RD or no clinical nutrition education (􏰁0.19 and 􏰁0.10, respectively). This study concluded that to be effective, clinical nutrition education should be delivered by an RD or a team that includes an RD.

5. An inpatient obesity intervention followed up with a post- discharge telephone call is an effective intervention for weight loss?

6. False
A prospective, randomized controlled trial in 2014 examined whether an inpatient weight loss intervention with post-discharge follow-up resulted in weight loss at 6 months when compared to the control group. The result: No difference in weight loss between the intervention and control groups at 6 months.

7. What Else Is The Research Saying?

8. Improvements in oral intakes of patients at risk of pressure ulcer with patient-centered nutrition intervention
Objective: To determine the effectiveness of a patient-centered intervention for improving the dietary intakes of patients at risk of pressure ulcer in hospital. Method: A 3-day intervention targeting patients at risk of pressure ulcer was developed, based on three main foundations: patient education, patient participation and guided goal setting. This was a pilot randomized control trial in 3 separate hospital wards.

9. Patient-Centered Nutrition Intervention
Result: 66 out of 80 patients viewed the intervention as motivating and met significantly more of their estimated energy and protein requirements over time. Conclusion: This pilot study indicates that the intervention is feasible and acceptable by patients at risk of pressure ulcer.

10. Inpatient Diabetes Education Is Associated With Less Frequent Hospital Readmission Among Patients With Poor Glycemic Control
Objective: To explore the relationship between inpatient diabetes education (IDE) and hospital readmissions in patients with poorly controlled diabetes.
Research Design & Method: Patients with a discharge diagnosis of diabetes (ICD-9 code 250.x) and HbA1c >9% who were hospitalized between 2008 and 2010 were retrospectively identified. All-cause first readmissions were determined within 30 days and 180 days after discharge. IDE was conducted by a certified diabetes educator or trainee..

11. Less Frequent Hospital Readmission From Effective Inpatient Nutrition Education
Result: In all, 2,265 patients were included in the 30-day analysis and 2,069 patients were included in the 180-day analysis. Patients who received IDE had a lower frequency of readmission within 30 days than those who did not (11 vs. 16%; P = ). Conclusion: Formal IDE was independently associated with a lower frequency of all-cause hospital readmission within 30 days.

12. Take Away From The Research
Education delivered by an RD or a team that includes an RD makes a difference.
Patient-centered education including patient participation and guided goal setting is effective.
Less frequent hospital readmission when patients received nutrition education during hospital stay.

13. Now That You Know
BASED ON WHAT WE’VE LEARNED TODAY, WHAT CAN RDS DO HERE AT ST. ANTHONY’S NORTH TO IMPROVE THE CURRENT NUTRITION EDUCATION TO BETTER SERVE OUR CLINICAL PATIENTS?

14. Questions

15. References
Healy SJ, Black D, Harris C, Lorenz A, Dungan KM. Inpatient diabetes education is associated with less frequent hospital readmission among patients with poor glycemic control. Diabetes Care Oct; 36(10): Epub 2013 Jul 8.
Roberts S, Desbrow B, Chaboyer W. Feasibility of a patient-centered nutrition intervention to improve oral intakes of patients at risk of pressure ulcer: a pilot randomized control trial. Scand J Caring Sci Jun 2.
Wachsberg KN, Creden A, Workman M, Lichten A, Basil A. Inpatient obesity intervention with post-discharge telephone follow-up: A randomized trial. J Hosp Med Aug; 9(8): Epub 2014 May 23.
Wilson C, Brown T, Acton K, Gilliland S. Effects of clinical nutrition education and educator discipline on glycemic control outcomes in the Indian Health Service. Diabetes Care Sep; 26(9):