TITLE THE DEVELOPMENT OF STANDARDS OF NUTRITIONAL CARE FOR

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TITLE THE DEVELOPMENT OF STANDARDS OF NUTRITIONAL CARE FOR Powered By Docstoc
					   TITLE: THE DEVELOPMENT OF STANDARDS OF NUTRITIONAL CARE FOR CHRONIC KIDNEY DISEASE

  AUTHOR(S): J.C. Smith, BS, Sage Graduate School Dietetic Internship, Troy, NY; M. Bell-Cavallino, MS,
RD, CDN, FADA, The Sage Colleges, Troy, NY


   LEARNING OUTCOME: To identify guidelines for standardized care by RDs for patients with chronic
kidney disease.


  Chronic Kidney Disease (CKD) is the progression of renal insufficiency resulting in renal failure. This
project aimed to develop a nutritional standard of care (SOC) for chronic kidney disease. The medical
center is in the process of developing SOCs for various conditions and CKD had not been addressed. The
SOC will provide dietitians at a 650 bed regional medical center a method of delivering consistent quality
nutrition care to patients with CKD. A literature review of the ADA’s MNT Evidence Based Guides for
Practice: CKD, ASPEN’s Nutrition Support Curriculum, and the NFK’s K/DOQI guidelines was completed.
Based on the review a new SOC was developed and includes: 1) a 48-hour timeline for completion of the
nutritional assessment following a positive nutrition screen, 2) 10 common PES statements for patients
with different stages of CKD, 3) 6 common subjective and/or objective nutritional considerations, 4)
nutrition prescriptions based on disease state and age for energy, protein , fluid, vitamin, mineral, and
supplement needs, 5) 10 common goals for the identification and treatment of patients, 6) 8 common
interventions to meet the goals for patients, and 7) monitoring and evaluation criteria for nutritional
risk; dry weight, laboratory values, and food and fluid take for adequacy. Initial reviews by the medical
center RDs indicated the SOC would be appropriate for this facility. The RDs agreed that the SOC would
be useful. This SOC will be added to the department’s resources for use to provide RDs with an up-to-
date standard of care for all CKD patients.