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  • Sage Journals (Sage Publications)  (6)
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Year
  • 1
    Language: English
    In: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, December 2014, Vol.29(6), pp.792-828
    Description: This 2014 revision of the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for Registered Dietitians Nutritionists (RDNs) in Nutrition Support represents an update of the 2007 Standards composed by content experts of the American Society for Parenteral and Enteral Nutrition and the Academy of Nutrition and Dietetics. The revision is based upon the Revised 2012 SOP in Nutrition Care and SOPP for RDs, which incorporates the Nutrition Care Process and the six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. These SOP and SOPP are designed to promote the provision of safe, effective, and efficient nutrition support services, facilitate evidence-based practice, and serve as a professional evaluation resource for RDNs who specialize or wish to specialize in nutrition support therapy. These standards should be applied in all patient/client care settings in which RDNs in nutrition support provide care. These settings include, but are not limited to, acute care, ambulatory/outpatient care, and home and alternate site care. The standards highlight the value of the nutrition support RDN's roles in quality management, regulatory compliance, research, teaching, consulting, and writing for peer-reviewed professional publications. The standards assist the RDN in nutrition support to distinguish his or her level of practice (competent, proficient, or expert) and would guide the RDN in creating a personal development plan to achieve increasing levels of knowledge, skill, and ability in nutrition support practice.
    Keywords: Clinical Competence ; Dietetics ; Dietitian ; Nutrition Care Process ; Nutrition Support Practice ; Nutrition Therapy ; Nutritional Support ; Professional Role ; Evidence-Based Medicine ; Quality of Health Care ; Dietetics -- Standards ; Enteral Nutrition -- Standards ; Nutritionists -- Standards ; Parenteral Nutrition -- Standards
    ISSN: 08845336
    E-ISSN: 1941-2452
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  • 2
    In: Nutrition in Clinical Practice, December 2012, Vol.27(6), pp.808-811
    Description: : Enteral nutrition has been demonstrated to reduce ventilator days and the incidence of pneumonia, but the safest route for providing enteral nutrition to mechanically ventilated patients is unclear. Our objective was to determine if there is a difference between the incidences of microaspiration of gastric secretions in patients fed via a nasogastric tube vs a postpyloric tube while undergoing rotational therapy for acute respiratory distress syndrome (ARDS). : Institutional review board approval was obtained for this prospective, randomized study. Patients were randomized to gastric or postpyloric enteral feedings. Daily tracheal secretion samples were collected, and we used an immunoassay to detect pepsin. Using the data for aspiration and tube type, a univariate unadjusted odds ratio was calculated to assess the risk of aspiration between the 2 tube types. An independent samples test was used to analyze the hypothesis that microaspiration significantly affects lung recovery from ARDS. : Of the 20 study patients, 9 (45%) received nasogastric feeds and 11 (55%) received postpyloric feeds. Western blot analysis for the presence of pepsin in each tracheal aspirate revealed microaspiration in 2 nasogastric (22%) and 2 (18%) postpyloric patients. The nasogastric tube provided a protective effect for aspirating with an odds ratio of .778 (95% confidence interval, .09–6.98). An independent samples test was used and showed no significant change in PaO:FiO ratio in the aspirating vs nonaspirating group ( = .552). : The results of this study indicate that enteral nutrition should not be delayed or stopped to position the tube in patients with ARDS on rotational therapy.
    Keywords: Enteral Nutrition ; Critical Illness ; Intensive Care Units ; Respiratory Distress Syndrome ; Adults ; Pneumonia ; Aspiration ; Respiratory Aspiration
    ISSN: 0884-5336
    E-ISSN: 1941-2452
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  • 3
    In: Journal of Parenteral and Enteral Nutrition, March 2009, Vol.33(2), pp.122-167
    Description: In developing the evidence-based Enteral Nutrition Practice Recommendations, the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) formed a task force to address the many aspects of safety in the delivery and provision of enteral nutrition support. This recently published document provides healthcare professionals with recommendations that are derived from evidence-based practice. The development and use of clinical practice guidelines (CPGs) is a recent, significant contribution for the dissemination of evidence-based medicine. This involves the review of scientific literature along with clinical skill and knowledge to generate specific recommendations assisting healthcare providers and patients with decisions regarding appropriate healthcare. A primary opportunity to improve patient outcomes will come from the effective delivery of existing therapies rather than from the new development of treatment modalities. Compliance with CPGs is challenging because it depends on a variety of factors. Both general and specific strategies have been devised with the expansion of the new discipline of implementation science. The high degree of evidence now available in medicine gives clinicians more opportunity to improve patient outcomes and quality of care. It remains for clinicians to evaluate their institutional mission and goals, and to investigate those CPGs appropriate to improve patient care in that setting.
    Keywords: Diet & Clinical Nutrition;
    ISSN: 0148-6071
    E-ISSN: 1941-2444
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  • 4
  • 5
    Language: English
    In: Research on Social Work Practice, May 2004, Vol.14(3), pp.137-146
    Description: The present study examines the relationship between race and treatment outcomes among clients receiving services at a community mental health agency in the rural southeastern United States. A nonprobabilistic sample of clients completed the BASIS-32, a self-report summated rating scale, at an initial assessment and a series of three follow-up assessments conducted at 3-month intervals. The data were analyzed using a hierarchical linear model (HLM) consisting of an individual growth model and a between-client model examining possible differences in growth trajectories attributable to race, diagnosis, socioeconomic status, and gender. Clients’ symptomatology remained stable or decreased during the study period. Of the demographic variables examined, only diagnosis was significantly related to variation in treatment outcomes. No racial differences in treatment outcomes emerged. Although the findings must be considered preliminary, they do suggest that community mental health agencies can effectively respond to various ethnic, cultural, and racial groups by providing appropriate and individualized services.
    Keywords: Mental Health ; Race ; Community Mental Health Centers ; Social Welfare & Social Work ; Psychology
    ISSN: 1049-7315
    E-ISSN: 1552-7581
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  • 6
    In: Nutrition in Clinical Practice, June 2009, Vol.24(3), pp.335-343
    Description: In developing the evidence‐based , the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) formed a task force to address the many aspects of safety in the delivery and provision of enteral nutrition support. This recently published document provides healthcare professionals with recommendations that are derived from evidence‐based practice. The development and use of clinical practice guidelines (CPGs) is a recent, significant contribution for the dissemination of evidence‐based medicine. This involves the review of scientific literature along with clinical skill and knowledge to generate specific recommendations assisting healthcare providers and patients with decisions regarding appropriate healthcare. A primary opportunity to improve patient outcomes will come from the effective delivery of existing therapies rather than from the new development of treatment modalities. Compliance with CPGs is challenging because it depends on a variety of factors. Both general and specific strategies have been devised with the expansion of the new discipline of implementation science. The high degree of evidence now available in medicine gives clinicians more opportunity to improve patient outcomes and quality of care. It remains for clinicians to evaluate their institutional mission and goals, and to investigate those CPGs appropriate to improve patient care in that setting.
    Keywords: Enteral Nutrition ; Practice Guideline ; Evidence‐Based Medicine
    ISSN: 0884-5336
    E-ISSN: 1941-2452
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