Compher C, Colaizzo T
Hospital of the University of Pennsylvania, Philadelphia 19104.
J Am Diet Assoc. 1992 Jul;92(7):807-12.
The Dietitians in Nutrition Support dietetic practice group of The American Dietetic Association administered a questionnaire to evaluate changes in nutrition support services provided to hospitalized patients and home patients in 1989 and compared the results with results of a survey administered in 1986. The 1986 survey documented an increase in tube feeding to inpatients during 1984 to 1986 and greater dietitian staffing in tertiary care hospitals than in primary care hospitals and in larger hospitals in 1986. The 1989 questionnaire was mailed to clinical nutrition managers from a nationwide random sample of 1,000 hospitals from American Hospital Association members; 271 responses were received. Full-time equivalent (FTE) registered dietitians (RDs)--including clinical RDs, nutrition support service RDs, and clinical nutrition managers--decreased 11% from 1986 to 1989. FTE dietetic technicians decreased 22%. The number of FTE nutrition support service RDs and clinical nutrition managers decreased significantly (P less than .05). The mean number of FTE clinical dietitians per 100 beds decreased from 1.4 to 1.0 from 1986 to 1989. These decreases in dietetics staffing occurred despite an overall increase in total hospital FTE staff of 2.9%. Reported daily provision of nutrition support modalities to inpatients was 3.5% for parenteral nutrition, 4.9% for enteral tube feeding, and 9.6% for oral supplements. Decreased dietetics staffing was accompanied by other factors that negatively affect productivity (and therefore ability to provide adequate patient care), including inadequate delegation of technical tasks to dietetic technicians, limited availability of secretarial and computer support, and minimal provision of pocket pagers. These trends may be evidence of inadequacy of dietetics staffing to meet the needs of the US population for nutrition care.
美国饮食协会营养支持饮食实践组的营养师于1989年进行了一项问卷调查，以评估为住院患者和居家患者提供的营养支持服务的变化，并将结果与1986年进行的一项调查结果进行比较。1986年的调查记录了1984年至1986年期间住院患者管饲的增加，以及1986年三级护理医院比初级护理医院和大型医院配备了更多的营养师。1989年的问卷被邮寄给了从美国医院协会成员的1000家医院的全国随机样本中选取的临床营养经理；共收到271份回复。全职等效注册营养师（包括临床注册营养师、营养支持服务注册营养师和临床营养经理）从1986年到1989年减少了11%。全职等效饮食技师减少了22%。全职等效营养支持服务注册营养师和临床营养经理的数量显著减少（P小于0.05）。每100张床位的全职等效临床营养师的平均数量从1986年的1.4降至1989年的1.0。尽管医院全职等效员工总数总体增加了2.9%，但饮食人员配备仍出现了这些减少。报告的住院患者每日营养支持方式的提供情况为：肠外营养3.5%，肠内管饲4.9%，口服补充剂9.6%。饮食人员配备的减少伴随着其他对生产力（进而对提供充分患者护理的能力）产生负面影响的因素，包括将技术任务委托给饮食技师不足、秘书和计算机支持的可用性有限以及很少提供传呼机。这些趋势可能表明饮食人员配备不足以满足美国人口对营养护理的需求。
