Laboratory Data: Clinical Dietitians' Perceptions Of Usefulness And Barriers

Abstract

This study sought to determine the usefulness of lab data to clinical dietitians and perceptions of barriers to that use. A questionnaire was mailed to 2000 inpatient hospital dietitians (RD). A total of 969 RDs responded; analysis involved only those who indicated they were currently employed as clinical dietitians (N-969). The most frequent uses of lab data were for assessment of nutrition status (85%), improving nutrition care (73%), and understanding the illness/disease state (72%). Uses were not dependent on age, years of experience, route to registration, or whether one held an advanced degree. Certified Nutrition Support Dietitians (CNSD) were less likely to use lab results to avoid malpractice (P=.03). Top perceived barriers included physicians failing to routinely order labs necessary for nutrition assessment (45%), lab results not routinely available (38%), and unresponsive physicians to requests for certain lab tests (20%). RDs in the 45-54 yr range were least likely to identify lack of time as a barrier (P=.002). Those who became RDs through the grandfather clause were most likely to note they were unsure about discussing lab values with patient or family (P=.002). RDs with advanced degrees were less likely to view lack of knowledge as an obstacle (P=.0001); those at the baccalaureate-level were more likely to identify lab results not routinely available (P=.01) as problematic. Both CNSD RDs (P=.03) and RDs certified as diabetes educators (P=.004) were more likely to identify that the physician does not routinely order necessary labs for nutrition assessment than were RDs not certified in these specialties. Although the uses for lab data were not unexpected, barriers would appear to indicate that better communication with physicians is warranted.