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Table 4 Delphi Round Two- Consensus Results (n = 26)

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
Where feasible, nutrition screening can be completed by the patient as part of the pre-admit documentation. (n = 25) 68.0 % (17) 24.0 % (6) 8.0 % (2) 0 92.0 % (23)
For non-elective admissions, nutrition screening occurs on day 1 or 2 of admission. 73.1 % (19) 11.5 % (3) 3.8 % (1) 11.5 % (3) 84.6 % (22)
SGA should be completed within 24 h of screening. 53.8 % (14) 38.5 % (10) 7.7 % (2) 0 92.3 % (24)
If patient is classified as SGA ‘C’, RD comprehensive assessment occurs on the same day. 46.2 % (12) 50.0 % (13) 3.8 % (1) 0 96.2 % (25)
Potential treatment options for the Advanced Nutrition Care should be flexible/individualized to the patient/setting. 76.9 % (20) 11.5 % (3) 3.8 % (1) 7.7 % (2) 88.5 % (23)
NPO status should be monitored on a daily basis. 80.8 % (21) 19.2 % (5) 0 0 100 % (26)
Being NPO for 3 days necessitates an RD comprehensive assessment (n = 25) 52.0 % (13) 24.0 % (6) 12.0 % (3) 12.0 % (3) 76.0 % (19)
In low-risk/well-nourished patients, food intake is monitored on Day 3 and 5 of admission using a meal intake form completed by the patient/family or Health Care Aid/Diet Technician. 46.1 % (12) 34.6 % (9) 19.2 % (5) 0 80.8 % (21)
If a low-risk patient has suboptimal food intake on day 3, they should be moved to Advanced Nutrition Care. (n = 24) 58.3 % (14) 33.3 % (8) 8.3 % (2) 0 91.2 % (22)
Suboptimal oral food intake for low-risk patients should be defined as <50 % of the meal. (n = 25) 56.0 % (14) 32.0 % (8) 8.0 % (2) 4.0 % (1) 88.0 % (22)
Patients receiving Advanced Nutrition Care should have their food intake monitored at minimum one meal per day. 46.2 % (12) 26.9 % (7) 19.2 % (5) 7.7 % (2) 73.1 % (19)
Lower-priority moderately malnourished (SGA 'B') patients receiving Advanced Nutrition Care should receive a comprehensive RD assessment if their food intake is suboptimal after two days of receiving standard treatment(s). 46.2 % (12) 42.3 % (11) 11.5 % (3) 0 88.5 % (23)
Suboptimal oral intake for lower priority B patients is defined as <50 % of the meal. (n = 25) 52.0 % (13) 40.0 % (10) 4.0 % (1) 4.0 % (1) 92.0 % (23)
Low-risk patients should have their body weight measured at minimum once/week. 65.4 % (17) 19.2 % (5) 15.4 % (4) 0 84.6 % (22)
Lower priority SGA B patients should have their body weight measured at minimum once/week. 65.4 % (17) 26.9 % (7) 7.7 % (2) 0 92.3 % (24)
Food intake, and not change in body weight, is the primary mechanism for determining a change in nutrition care (e.g. from Standard Nutrtion Care to Advanced Nutrition Care) for low risk and lower priority SGA B patients. 76.9 % (20) 19.2 % (5) 3.8 % (1) 0 96.2 % (25)
Suboptimal oral intake for consideration of AFN should be < 50 % of offered meals and supplements. (n = 25) 52.0 % (13) 44.0 % (11) 4.0 % (1) 0 96.0 % (24)