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Nutrition Services in Canadian Neonatal Intensive Care: The Role of the Dietitian.

Inclusion of registered dietitians/nutritionists (RDNs) on the neonatal intensive care team has been shown to improve nutrition and growth rates in high-risk infants, shortening their hospital stay. To determine the role of RDNs, 55 neonatal intensive care units (NICUs) and post-discharge services in Canada were surveyed. The response rate was 69%. RDNs were involved in 73% (8/11) of level II and 92% (24/26) of level III units. The average RDN time devoted to the NICU, in full-time equivalents, was 0.2 in level II and 0.5 in level III units. More than 90% of the RDNs develop, evaluate, and modify nutrition care plans, and then document interventions in the health record. Seventy-nine percent of the RDNs participate in teaching rounds and patient care conferences, and make referrals to the community. All of the RDNs instruct patient families. Seventy-one percent of respondents provide family follow-up care after hospital discharge. Forty-six percent work with families of NICU graduates with feeding difficulties. Eighty-two percent provide education to other health professionals. Sixty-eight percent participate in research projects, initiating the majority of these projects. These results provide pertinent information for clinical leaders seeking to establish a role for the clinical dietitian in neonatal intensive care. For those already working in NICUs, the results may provide some guidance on role definition and expansion.