Definition of Terms, Style, and Conventions Used in A.S.P.E.N. Guidelines and Standards

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141145/1/ncp0281.pd

Hospital Nutrition Assessment Practice 2016 Survey

BackgroundMalnutrition is a significant problem for hospitalized patients in the United States. Nutrition assessment is an important step in recognizing malnutrition; however, it is not always performed using consistent parameters.MethodsA survey among U.S. American Society for Parenteral and Enteral Nutrition (ASPEN) members was conducted to collect data on nutrition assessment parameters used in hospitals and to establish how facilities use their electronic health record (EHR) to permit data retrieval and outcome reporting.ResultsThe survey was developed by the ASPEN Malnutrition Committee and was sent to 5487 U.S. ASPEN members, with 489 responding for a 9% response rate. Ninety‐eight percent of adult and 93% of pediatric respondents indicated a registered dietitian completed the nutrition assessment following a positive nutrition screen. Variables most frequently used among adult respondents included usual body weight, ideal body weight, and body mass index. Among pediatric respondents, weight‐for‐age and height‐for‐age percentiles and length/height‐for‐age percentile were most frequently used. Both adult and pediatric respondents indicated use of physical assessment parameters, including muscle and fat loss and skin assessment. Eighty‐seven percent of adult and 77% of pediatric respondents indicated they are using the Academy of Nutrition and Dietetics (Academy) and ASPEN Consensus Malnutrition Characteristics for Adult and Pediatric Malnutrition, respectively. Overall, 97% of respondents indicated nutrition assessment documentation was completed via an EHR. Of all respondents, 61% indicated lack of clinical decision support within their EHR.ConclusionThis survey demonstrated significant use of the Academy/ASPEN malnutrition consensus characteristics.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146497/1/ncp10179_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146497/2/ncp10179.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146497/3/ncp10179-sup-0001-FigureS1.pd

Nutrition Screening and Assessment in Hospitalized Patients

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141744/1/ncp0483.pd

Characteristics of Hospitalized Children With a Diagnosis of Malnutrition

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141004/1/jpen0623-sup-0001.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141004/2/jpen0623.pd

Hangover and Hydration Therapy in the Time of Intravenous Drug Shortages

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141258/1/jpen0921.pd

Standardized Competencies for Parenteral Nutrition Prescribing: The American Society for Parenteral and Enteral Nutrition Model

Parenteral nutrition (PN) provision is complex, as it is a high-alert medication and prone to a variety of potential errors. With changes in clinical practice models and recent federal rulings, the number of PN prescribers may be increasing. Safe prescribing of this therapy requires that competency for prescribers from all disciplines be demonstrated using a standardized process. A standardized model for PN prescribing competency is proposed based on a competency framework, the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)–published interdisciplinary core competencies, safe practice recommendations, and clinical guidelines. This framework will guide institutions and agencies in developing and maintaining competency for safe PN prescription by their staff

The use of visceral proteins as nutrition markers: an ASPEN position paper

Serum albumin and prealbumin, well-known visceral proteins, have traditionally been considered useful biochemical laboratory values in a nutrition assessment. However, recent literature disputes this contention. The aim of this document is to clarify that these proteins characterize inflammation rather than describe nutrition status or protein-energy malnutrition. Both critical illness and chronic illness are characterized by inflammation and, as such, hepatic reprioritization of protein synthesis occurs, resulting in lower serum concentrations of albumin and prealbumin. In addition, the redistribution of serum proteins occurs because of an increase in capillary permeability. There is an association between inflammation and malnutrition, however, not between malnutrition and visceral-protein levels. These proteins correlate well with patients' risk for adverse outcomes rather than with protein-energy malnutrition. Therefore, serum albumin and prealbumin should not serve as proxy measures of total body protein or total muscle mass and should not be used as nutrition markers. This paper has been approved by the American Society for Parenteral and Enteral Nutrition Board of Directors.Published versio

A Call to Action for Optimizing the Electronic Health Record in the Parenteral Nutrition Workflow

Parenteral nutrition (PN) is a complex therapeutic modality provided to neonates, children, and adults for various indications. Surveys have shown that current electronic health record (EHR) systems are in need of functionality enhancement for safe and optimal delivery of PN. This is a consensus statement from the American Society for Parenteral and Enteral Nutrition, the Academy of Nutrition and Dietetics, and the American Society of Health‐System Pharmacists outlining some of the key challenges to prescribing, order review/verification, compounding, and administration of PN using EHRs today and is a call to action for clinicians and vendors to optimize their EHRs regarding the PN build and workflow.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146340/1/ncp10095.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146340/2/ncp10095_am.pd

A Call to Action for Optimizing the Electronic Health Record in the Parenteral Nutrition Workflow: Executive Summary

Parenteral nutrition (PN) is a complex therapeutic modality provided to neonates, children, and adults for various indications. Surveys have shown that current electronic health record (EHR) systems are in need of functionality enhancement for safe and optimal delivery of PN. This is a consensus statement from the American Society for Parenteral and Enteral Nutrition, the Academy of Nutrition and Dietetics, and the American Society of Health‐System Pharmacists outlining some of the key challenges to prescribing, order review/verification, compounding, and administration of PN using EHRs today and is a call to action for clinicians and vendors to optimize their EHRs regarding the PN build and workflow.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146349/1/ncp10202.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146349/2/ncp10202_am.pd