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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