The Use of a Nutritional Diagnostic Service in a Long Term Setting

Abstract

Due to a growing elderly population and continuing health care reforms, the acuity level of residents within the long term care community is rapidly increasing. The technological level of clinical methods associated with this change needs to concurrently increase in order to provide optimal patient care and to meet ever changing regulatory guidelines. In response to this growing need, the nutritional diagnostic service was developed. The service is a portable, mobile system which provides nutritional diagnostic testing with complete interpretation. Testing is administered by a trained technician and the interpretation is provided by the team's medical director with input from the team's clinical dietitian. Procedures provided include indirect calorimetry, (with pulse oximetry), bioelectrical impedance analysis and hand grip dynamometry. Interpretation includes an analysis of these procedures, practical recommendations and a drug-nutrient interaction profile. Use of this service to date has revealed significant differences between results of universally accepted energy equations versus measured requirements and between estimates of body composition and fluid status via anthropometries and lab data versus measured impedance. As a result of this service, practitioners: 1) obtain the most accurate information concerning calorie needs, body composition and fluid status that is currently available in a clinical setting. 2) have access to technology which was previously unavailable to this population of patients. 3) provide more viable and clinically accurate care plans than would otherwise be possible using current, standard assessment techniques. 4) can potentially contribute to health care cost efficiency by using technology that promotes earlier and more accurate interventions.