The role of the dietitian in the ICU is to develop, implement and monitor nutritional strategies and interventions to meet the unique needs of critically ill patients in ICU.
Critically ill patients often require one or more form of organ support (such as respiratory support) further complicating the nutritional requirements of critically ill patients. Deterioration of nutrition status in critically ill patients is associated with longer ICU and hospital length of stay, poorer functional outcomes, increased risk for infections and higher mortality.
The dietitian will follow a systematic process in line with clinical guidelines and standards to calculate the patient’s estimated requirements construct a nutrition care plan and monitor the efficacy of the nutritional care plan.
Many ICU patients struggle to meet their nutritional requirements with food alone and might need extra special supplements that the dietitian will recommend and order for these patients.
Patients in ICU unable to eat balanced meals may receive enteral nutrition (a specialised feeding formula given via a tube in the stomach or small bowel).
Patients with an inaccessible gut for feeding may require parenteral nutrition (a complex nutritional formula administered via a central or peripheral line into a vein). This requires knowledge of diseases, the impact of diseases on nutrition and nutritional status assessment and monitoring.
Critically ill patients in the ICU will in most instances be seen daily by the dietitian.
The dietitian has to monitor the patient for tolerance of the feeding formula and changes in the disease process which may necessitate a change in the feeding formula or nutritional intervention.
Critically ill patients can have drastic and sudden changes in their condition which may impact directly on the patient’s nutritional requirements such as a high fever. Daily dietetic involvement will ensure optimised nutritional care in the ICU.
Dietitians are registered health professionals and act as independent practitioners registered at the Health Professions Council of South Africa (HPCSA). The practice will invoice your medical aid if you are admitted to an ICU in a private hospital.
All fees and services are invoiced at the recommended fees structure according to the medical aids. All different medical aid plans offer different levels of benefits for dietitian services. In the event that the medical aid does not cover the full service, the patient or the family of the patient remain responsible for the payment.
The dietitian’s account is completely separate from those of the hospital, doctors and other medical service providers.
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