Outcomes of dietitian involvement with leukemia patients receiving total parenteral nutrition

by Mattson, Christine.

Mattson Christine D. (Writer) (Last Name) (First) (Initial) Outcomes of Dietitian Involvement With Leukemia Patients Receiving Total Parenteral Nutrition (Title) Food and Nutritional Sciences Dr. Carol Seaborn May/2002 104 (Graduate major) (Research Advisor) (Month/Year) (No. of Pages) Turbian, Kate L. Manual for Writers of Term Papers, Theses, and Dissertations (Name of Style Manual Used in the Study) There is an increasing need for justification of medical nutrition therapy given by the dietitian. With health care costs escalating rapidly, practitioners need to demonstrate that they can improve patient outcomes. Outcomes research provides a practical approach to health care evaluation. The purpose of this study is to determine if the amount of involvement by a registered dietitian with leukemia patients on total parenteral nutrition (TPN) improves outcomes. The outcomes included in this study were 1) length of inpatient stay, 2) length of TPN administration, 3) percentage of energy needs met by the TPN, 4) weight change, and 5) visceral protein status measured by serum albumin on admission and discharge. Dietitian involvement was defined as the percentage of recommended follow up documentations achieved (meeting the protocol of ii documentation every four days). A retrospective study of 115 medical records from adult patients with leukemia was conducted. The types of leukemia included were, acute myelogenous leukemia, acute lymphocytic leukemia, chronic myelogenous leukemia, and chronic lymphocytic leukemia. Data was analyzed using SPSS statistical analysis software. Timely dietitian involvement was indirectly correlated with length of days on TPN (r = -0.211, p = 0.026), and positively correlated with percentage of energy needs met (r = 0.028, p = 0.012). No significant associations were observed for length of inpatient stay, weight change, or visceral protein status. These results suggest that the dietitian can improve patient outcomes by decreasing the number of days on TPN as well as meeting essential energy requirements. This study demonstrates dietitian intervention produced better patient outcomes as well as potential cost savings to the institution. iii