Table 3 Delphi Round One- Consensus Results
From: The Integrated Nutrition Pathway for Acute Care (INPAC): Building consensus with a modified Delphi
Question/Statement | % Totally Agree (N) | % Somewhat Agree (N) | % Somewhat Disagree (N) | % Totally Disagree (N) | % Totally/Somewhat Agreed |
|---|---|---|---|---|---|
Nutritional screening is necessary upon admission for all non-traumatic medical and surgical patients. | 82.1 (23) | 17.9 (5) | 0 | 0 | 100 |
Pre-admission screening is appropriate for elective admissions. (n = 27) | 74.1 (20) | 22.2 (6) | 3.7 (1) | 0 | 96.3 |
If deemed nutritionally “at risk” after initial screening, a subjective global assessment (SGA) will be completed. | 71.4 (20) | 21.4 (6) | 7.1 (2) | 0 | 92.9 |
If SGA classifies a patient as moderately malnourished ('B') but a lower priority for individualized assessment and treatment, Advanced Nutrition Care strategies should be implemented (i.e. higher protein diet). | 67.9 (19) | 28.6 (8) | 3.6 (1) | 0 | 96.4 |
If SGA classifies a patient as "severely malnourished" ('C'), the patient should be referred to the RD for comprehensive assessment and individualized treatment. | 100 (28) | 0 | 0 | 0 | 100 |
Nutrition care of patients referred for comprehensive assessment should be individualized based on the treatment plan prescribed by the RD. | 82.1 (23) | 17.9 (5) | 0 | 0 | 100 |
Nutrition monitoring of patients referred for comprehensive assessment should be individualized based on the treatment plan prescribed by the RD. | 78.6 (22) | 14.3 (4) | 3.6 (1) | 3.6 (1) | 92.9 |
Frequency of monitoring should increase with increased level of nutritional risk/malnutrition. (n = 27) | 77.8 (21) | 22.2 (6) | 0 | 0 | 100 |
All non-traumatic medical/surgical patients should have their body weight measured at admission. | 85.7 (24) | 14.3 (4) | 0 | 0 | 100 |
Body weight should be measured regularly as a gauge for changes in nutritional status in all non-traumatic medical/surgical patients. | 60.7 (17) | 21.4 (6) | 17.9 (5) | 0 | 82.1 |
For patients admitted as low-risk/well-nourished, artificial food & nutrition (AFN) should be considered if intake is suboptimal for 7-10 days post admission. (n = 27) | 63.0 (17) | 25.9 (7) | 11.1 (3) | 0 | 88.9 |
For patients admitted as malnourished, AFN should be considered if intake is suboptimal for 3 days post-admission. (n = 26) | 53.8 (14) | 30.8 (8) | 15.4 (4) | 0 | 84.6 |
If a patient was identified as malnourished (SGA B/C) on admission, the patient/family should be provided with recommendations to improve nutritional status post discharge. | 89.3 (25) | 7.1 (2) | 3.6 (1) | 0 | 96.4 |
If nutrition is still an issue at discharge, nutrition transfer recommendations should be embedded in discharge communications for their community health care professionals. | 100 (28) | 0 | 0 | 0 | 100 |