ORCID

https://orcid.org/0009-0000-3418-5224

Year

2024

Season

Summer

Paper Type

Doctoral Dissertation

College

Brooks College of Health

Degree Name

Doctor of Clinical Nutrition (DCN)

Department

Nutrition & Dietetics

NACO controlled Corporate Body

University of North Florida. Department of Nutrition & Dietetics

First Advisor

Dr. Casey Colin, DCN, RDN, LDN, FAND

Second Advisor

Dr. Lauri Wright, PhD, RDN, LDN, FADA

Third Advisor

Dr. Constantina Papoutsakis, PhD, RD

Department Chair

Andrea Arikawa, PhD, MPH, RD, LD/N, FAND

College Dean

Mei Zhao, PhD

Abstract

Objectives: This study explored practice patterns and documentation quality of RDNs caring for breastfeeding dyads.

Methods: This pilot registry study was conducted with an observational study design, including 9 RDNs documenting 275 nutrition care encounters with breastfeeding dyads in the Academy of Nutrition and Dietetics Health Informatics Infrastructure (ANDHII) from 2021 and 2024. We assessed the frequency of Nutrition Care Process Terminology (NCPT), documentation quality using the Nutrition Care Process Quality Evaluation and Standardization Tool (NCP-QUEST), nutrition diagnosis resolution, and predictors of nutrition diagnosis resolution.

Results: Breastfeeding difficulty (24%; 96 of 283) was the most frequently documented nutrition problem. Breastfeeding difficulty (17%; 28 of 163) and food and nutrition-related knowledge deficit (22%; 25 of 114) were the most common etiologies for infants and parents. The primary interventions were food and/or nutrient delivery (43%; 210 of 484), coordination of nutrition care (15%; 73 of 484), and nutrition education (15%; 74 of 484). The most frequently resolved nutrition diagnoses were breastfeeding difficulty (N=6; 18.8%), underweight (N=5; 15.6%), predicted breastfeeding difficulty (N=4; 12.5%), and inadequate vitamin D intake (N=4; 12.5%). Presence of the goal-intervention link (OR 1.032, 95% CI [1.044-7.543], p=0.041), and number of nutrition diagnoses documented (OR 1.223, 95% CI [1.253-9.208], p=0.016) were predictors of nutrition diagnosis improvement.

Conclusion: RDN care improves nutrition problems in breastfeeding dyads. Training should focus on NCPT utilization in nutrition care documentation, particularly in public health settings. Our findings support the development of lactation-specific NCPT and ANDHII and highlight the need for improved training for lactation RDNs.

Available for download on Monday, July 23, 2029

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