Gaps in Nutrition Care Process by a Multidisciplinary Team

Abstract

Abstract
1) To describe the process in the nutritional care system; and 2) to explore gaps in
nutritional care and approaches to nutritional care system improvement in a tertiary hospital.
Design: Qualitative research.
Methodology: Nine informants in the nutrition care team were recruited to form a
focus group, consisting of 2 physicians, 2 nurses, 3 dietitians, and 2 pharmacists. Data were
collected through focus group discussion and in-depth interviews. The data were then
analysed using content analysis.
Results: The implementation of the hospital’s nutrition care system consisted of three
parts: 1) the structure; 2) the process, comprising nutritional assessment, coordination,
referral, and nutritional therapy and monitoring; and 3) the outcome of the process. The gaps
in the nutritional care system, and hence the necessary approaches to its improvement, were
related to: 1) the staff’s work overload; and 2) disproportion between manpower and
increased workload. Possible solutions included adjustment of the work system to achieve a
better balance between the work scope, workload, and current manpower, which would result
in more effcient teamwork.
Recommendations: In tertiary hospitals, where the number of patients is usually large
and the complexity of the diseases is high, appropriate and systematic management of nutritional
care is extremely important. Proper nutritional therapy conducted by a multidisciplinary team
is required. However, as no clear standard has been established, the administrationof nutritional
care varies amongst healthcare practitioners. It is necessary, therefore, that hospitals clearly
defne the work scope, workload, policies, and career paths for their personnel.