Organization of the Dietetic Service in a Hospital

Study Overview
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Brief Summary
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In Denmark the dieticians can be organized centrally and called upon if needed, or locally in larger units, or very locally related to bed-units. The organization form is based on tradition not on measurements of quality. We wanted to compare the very local form with the traditional centralized. Methods: Randomized, unblinded, parallel design. The intervention group (IT) was nutritionally handled by the dietician, and the control group (C) by the nurses as previously with the possibility for dietetic help from the center.

Detailed Description
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All patients were screened by NRS-2002 and had their estimated needs calculated (equations in IT, tables in C). The IT was in addition assessed for adapted weight-loss, counseled with a plan for nutrition and followed-up daily by the dietician if at nutritional risk. All patients were re-screened weekly and had their intake registered. Hand-grib-strength (HGS) was measured in both groups at admittance and discharge, and weight three times weekly. The primary endpoint was re-admission rate to hospital within 2 months.

Official Title
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Organization of the Dietetic Service in a Hospital - on the Ward or Centralized?

Conditions
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Nutritional Disease, Malnutrition

Intervention / Treatment
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* Procedure: Nutritional assessment and therapy
* Procedure: Standard care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adult acutely admitted to hospital Exclusion Criteria: dementia unable to comply with the protocol

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomized controlled
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Dietetic service<br>Nutritional assessment and therapy by dietitian throughout the hospital stay | Procedure: Nutritional assessment and therapy<br>* Nutritional screening, nutritional plan, follow-up and instructions on discharge<br>|
| Placebo Comparator: standard care<br>Nutritional handling by nurses supported by a dietician if needed | Procedure: Standard care<br>* Nutritional handling by nurse<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| re-admission-rate after discharge (%) | admission for the same diagnosis | 2 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| intake of protein during hospital stay | % of estimated needs | 1 week | 
| intake of energy during hospital stay | % of estimated needs | 1 week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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dietitic service, organization of service