A survey of the role of the dietitian in preparing patients for home enteral feeding.
Teaching home enteral feeding is a complex process involving many activities not traditionally performed by dietitians. This survey was undertaken to investigate (a) tasks performed by the dietitian in preparing patients to receive home enteral feeding, (b) the effect of various demographic factors on the dietitian's role, (c) the amount of dietitian time spent preparing a patient for discharge on home enteral feeding, and (d) the types of home enteral feedings currently in use. A questionnaire was tested for reliability and validity, then mailed to 1,168 nutrition support dietitians. Results of the survey indicated that, more often than nurses or physicians, dietitians were responsible for calculating nutrient and fluid needs, selecting formula, determining the home feeding schedule, teaching the patient to prepare blenderized formulas, and teaching the patient to recognize formula intolerance. Dietitians were less often responsible than nurses for psychomotor skills such as teaching the patient to administer the formula, operate the pump, and flush the feeding tube. Dietitians seemed to have a larger role in hospitals with more than 499 beds, in teaching hospitals, and in hospitals with a nutrition support team. Dietitians reported a smaller role when they reported to a contract foodservice company and when their job duties were divided so that more time was spent in clinical dietetics than in nutrition support. However, dietitians in all demographic groups performed all tasks. The average amount of dietitian time spent preparing patients for discharge on home enteral feeding was 168 minutes (2.8 hours) per patient. More patients received gastric feedings (76%) than intestinal feedings (22%).(ABSTRACT TRUNCATED AT 250 WORDS)