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Nutrition Provider Isolation Is Related to Increased Preference for Enteral Nutrition–Support in Patients With Advanced Dementia
Author(s) -
Douglas Joy W.,
Lawrence Jeannine C.,
Knol Linda L.,
Turner Lori W.,
Ellis Amy C.
Publication year - 2020
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1002/ncp.10453
Subject(s) - medicine , psychological intervention , logistic regression , population , dementia , isolation (microbiology) , family medicine , acute care , aged care , gerontology , nursing , health care , disease , environmental health , microbiology and biotechnology , economics , biology , economic growth
Background Current guidelines advise against using enteral nutrition (EN) support for patients with advanced dementia (AD) because of negative outcomes. However, research suggests that some registered dietitian nutritionists (RDNs) in acute‐care settings still recommend EN for this patient population. The purpose of this study was to identify workplace characteristics that influence the EN recommendations of acute‐care RDNs who care for patients with AD. Methods A random sample of 5000 RDNs in the United States were invited to participate in a web‐based survey in which RDNs self‐reported the likelihood that they would recommend EN for a patient with AD. Inclusion criteria specified that participants were at least 18 years of age, were an RDN in the United States, and currently provide nutrition care to older adults with dementia. χ 2 tests compared RDN recommendations by workplace characteristics. Logistic regression was used to determine factors associated with recommending EN for patients with AD. Results Respondents included 204 acute‐care RDNs. RDNs in rural or suburban locations were 2.4 times more likely to recommend EN compared with those in urban facilities (95% CI, 1.1–5.1). RDNs who were the only nutrition provider at their facility were 3.3 times more likely to recommend EN than those in facilities with multiple RDNs (95% CI, 1.4–7.9). Conclusion Acute‐care RDNs who are isolated either in rural facilities or because they lack other RDN colleagues at their facility may benefit from targeted interventions to increase knowledge and promote adherence to evidence‐based guidelines.