Based on actual questions received for nutritionDay in the U.S. The questions are sequenced according to the nutritionDay processes.
GENERAL nutritionDay INFORMATION:
When is nutritionDay in the US?
The worldwide nutritionDay participation, including the US, is annually on a Thursday in November. Or, you can designate your own facility nutritionDay in the US. Please note data collection for nutritionDay could occur on more than one day due to staffing constraints or an inadequate number of patients to meet the minimum of 20 patients per unit for statistical significance.
What type of facilities and patients can participate in nutritionDay?
Non-ICU patients
ICU patients
Skilled Nursing Home Patients
Home Healthcare Patients
Non-Breast Fed Pediatric Patients
Is nutritionDay in the ICU performed on a different day than the non-ICU?
No, all units participate in nutritionDay on the same day. Keep in mind that you only need one unit to participate.
If I didn’t participate in nutritionDay last year, can I participate this year?
Yes, we recommend annual participation thereafter to obtain annual benchmarking of your facility.
Does any data need to be collected before nutritionDay?
You may want to do the following before nutritionDay:
- Submit a waiver to the IRB, if this required by your facility
- Educate clinicians involved with nutritionDay
- Perform a trial nutritionDay on one patient
- Complete Sheet 1 for ICU and non-ICU patients
- Receive patient consent, if this is required by your facility
Does the whole facility participate in nutritionDay?
All that is required to participate in nutritionDay is one unit, ICU or non-ICU, with a minimum of 20 patients.
What if I do not have 20 patients in the participating unit on nutritionDay?
We recommend you conduct nutritionDay on more than one day immediately following nutritionDay in the same unit until you have reached at least 20 patients.
Can we combine ICUs to achieve 20 patients on nutritionDay?
No units can be combined to meet the minimal patient participation requirements. Since ICU Sheet 1 may vary for the other ICU, we would need to have the 2 ICUs entered separately. If you do not have 20 patients in one unit on nutritionDay, you can perform nutritionDay on subsequent days until you have adequate patient participation
Can home healthcare patients participate in nutritionDay?
Yes, the nursing home information (Protocol, forms etc.) will need to be used since home healthcare patients are long term care. Each home healthcare facility would be consider one unit. The facility could be the corporate group or the facility.
We are reviewing our current forms and look forward to developing forms specifically for the home healthcare community.
Which clinicians can participate in nutritionDay?
Any clinician involved with patient care. However, we recommend that the project lead at your facility be involved with the patient nutritional care as well.
nutritionDay participation is a great opportunity to include multiple disciplinaries in your facility
nutritionDay is a great project for students and interns. However, we recommend that students and interns do not assist with the ICU participation, due to the complexity of the patient.
How much time is needed to educate the clinicians that are assisting with nutritionDay?
It will depend on their role and responsibility. However, training the clinician should not take more than 30-60 minutes. We would also recommend a trial nutritionDay on one patient prior to nutritionDay, in addition to your training.
INTERNAL REVIEW BOARD (IRB) PROCESS
Does the program have IRB approval or does each facility need to receive the approval of their IRB?
nutritionDay Worldwide does have IRB/Ethics approval. This information can be found on the global website, www.nutritionday.org
However, some facilities require IRB approval from their facility. We recommend an IRB waiver or an expedited process. The patient care on nutritionDay does not change. The data taken from the patient may vary from standard of practice. Also all facilities and patient information is anonymous through a coding process. The IRB process may be eased by working with your pharmacy.
You may also consider approaching your quality control team and use nutritionDay as a benchmarking initiative for nutritional care accreditation purposes.
What is the exclusion criteria?
Breast fed infants
Any patient admitted or discharges on nutritionDAy
All patients on the participating unit on nutritionDay should be encouraged to participate
Is the data anonymous?
Yes, your first year of participation, you will need to apply for your facility code and unit code on www.nutritionday.org. Patient identification is also coded. Only the codes are submitted with the nutritionDay data.
Does the patient’s birthday need to be included on the forms?
No, only the birth year is included on Sheet 2 of the non-ICU and nursing home forms. Age is included on sheet 2 of the ICU form.
Are sample protocols available:
Yes, a sample protocol available on our website under Hospital or Nursing Homes or by contacting office@nutritionDayUS.org.
Is the 2014 protocol available on nutritionday.org still current?
Yes
Do we need to obtain patient consent for the records kept by nutritionDay?
Follow your hospitals policies for the need for a patient consent for a minimally invasive study, registry or audit. A patient consent is not required by nutritionDay
APPLYING FOR FACILITY AND UNIT CODES:
Please clarify whether we use the unit codes listed on Sheet 1 or if we are supposed to request different codes from you to use?
You will need to apply for a facility and unit code on www.nutritionday.org, order codes. These codes are different than the codes listed on Sheet 1. The same unit code(s) can be used year over year.
After applying online for my facility codes, when do they become active?
You must respond to a confirmation email from nutritionDay.org, which is sent to your email promptly after applying for these codes
FORMS:
(Please refer to Explanations and Definitions available on our website for detailed form information)
GENERAL INFORMATION
Are the forms available in different languages?
Yes, however, only the English U.S. forms, as described on the www.nutritionday.org, have been adjusted for the U.S. medical community. Check with your Internal Review Board if you would like to use forms in other languages besides English.
If a patient did not consent to participate, should I enter them in the data entry?
Yes
NON-ICU FORMS
Sheet 1
“Is there a Clinical Nutrition Team at your facility?” Is this referring to a Nutrition Support Team or a team of dietitians?
Nutrition Support Team
Do we include all physicians and consultants for each patient? Or just if we have specific physicians and consultants assigned to the unit?
Just the physicians and consultants assigned to the unit
Sheet 2
When counting days since unit or hospital admission should we count the day of admit as day 1 and continue counting including the day of the survey?
Yes
What number do we assign diabetic diet? (The instructions indicate to exclude if from special diet.)
Use special diet/4
If an energy goal is not assessed, do we just not complete that area of the question or do we assign one?
Do not change your clinical practice on nutritionDay. Leave an area blank if it does not apply to your facility. In this situation you could enter the energy goal if you would like to calculate it.
Are we asking about pills and liquid medications at home or in the hospital?
Any oral medication taken on nutritionDay
Sheet 3a and 3b
Are we asking about pills and liquid medications at home or in the hospital?
Any oral medication taken on nutritionDay
If a patient ate less than ¼ , like a few bites, or more than 1/2, which plate should we check on 3b?
This would require your clinical judgement on rounding up or down.
For fluid consumption, How do I fill in the data?
1 drink = 200 mL. Please fill in number of drinks based on this conversion. If a partial drink was consumed, use fractions or decimals (please use a period not a comma when using decimals) to designate the quantity
ICU FORMS
What is PaO2/FiO2 on the ICU Sheet 3?
PaO2/FiO2 is an index of arterial oxygenation efficiency that corresponds to ratio of partial pressure of arterial O2 to the fraction of inspired O2
PaO2 is the partial pressure of oxygen in blood – you catch this value with the blood gas analysis (mmHg)
FiO2: is the fraction inspiration of oxygen (%)
Sheet 3:
Does the Ramsey Score need to be completed if the patient is not sedated?
If this is your current practice, please do not change any of your processes or policies for nutritionDay. So if you do not perform a Ramsey Score on patients that are not sedated, do not complete the Ramsey Score for nutritionDay.
If a patient is taking nutrition orally and not on nutrition support, how do I specify that on the ICU forms?
This is briefly asked on Sheet 4 of the ICU forms. Do not use the non-ICU form 3a/3b for ICU patients.
UNIT PATIENT LIST AND OUTCOME
Does the outcome data need to be collected on exactly day 30 for non-ICU patients and exactly day 60 for ICU patients?
No, however, use day 30 or 60 when reviewing the chart to understand the status of the patient on that day.
On the outcome data, if a patient is discharged to home healthcare, is that considered discharged home?
Yes
If the patient has multiple ICD – 9 (U.S. is ICD -9 vs. ICD 10) codes which code should be used?
The first priority code
If the patient was readmitted and than discharged home before the outcome data is collected, do we list the outcome as readmitted or discharged home?
Readmitted
DATA ENTRY:
Is it possible to enter some data, exit the website and enter the remaining data at a later date?
Yes, just make sure all your data is entered before the data entry shuts down for data analysis. This usually occurs 30 days after the outcome data is collected.
Is the same ID and password for entering nutritionDay.org used for data entry?
No
non-ICU use the following:
ID: (facility code)nd(unit code)
Password: (unit code)
ICU use the following:
ID: (facility code)icu(unit code)
Password: (unit code)
Nursing Home use the following:
ID: (facility code)nh(unit code)
Password: (unit code)
What is the timeline for data entry after nutritionDay?
Electronic data entry can occur one day following nutritionDay and remain open until 10-14 days after outcome data is collected. The data entry will than shut down to prepare the preliminary data report. The electronic data entry will re-open a couple of days after and remain open for approximately one more month/mid February.
WEBSITE:
What is the official website for nutritionDay?
The global website is www.nutritionday.org. This site contains everything you need to participate in nutritionDay in the U.S.
We are continuously working on a U.S. site. We will provide information on nutritionDay in the U.S. specifically. Suggestions are always welcome, office@nutritionDayUS.org
How do I obtain information on nutritionDay in the U.S. on the global site?
Click on nd in the U.S. on the bottom right corner.
Which forms should I use for nutritionDay in the U.S.?
English, U.S.
REPORTS:
Are sample reports available?
Yes, please contact office@nutritiondayus.org or office@nutritionday.org
Will the nutritionDay data be compared to European or U.S. facilities?
For statistical reasons, once we receive participation of at least 100 of each type of unit in the U.S., your facility will be benchmarked against other similar facilities in the U.S. Until that time, the U.S. participating facilities will be benchmarked against all other worldwide participating facilities with the same unit type. We have found this comparison to be very insightful.
How will the facility data be used by nutritionDay?
The facility data will be anonymous and will be used as an aggregate with the rest of the data submitted for nutritionDay. This data may be presented at association meetings, educational programs, publications and other forms of the media to raise awareness about the prevalence of healthcare malnutrition.
