PD119 - CLINICAL NUTRITION IN DOMINICAN PUBLIC HOSPITALS: A NATIONWIDE MATURITY INDEX REVEALS GAPS BETWEEN AVAILABILITY AND IMPLEMENTATION

PD119

CLINICAL NUTRITION IN DOMINICAN PUBLIC HOSPITALS: A NATIONWIDE MATURITY INDEX REVEALS GAPS BETWEEN AVAILABILITY AND IMPLEMENTATION

J. Cepeda Marte^1,*, M. Lazo Zumaeta¹, J. F. Balaguer Santos¹, S. Carmenate Suarez¹, S. Ochoa Muñoz¹, K. Polanco Lima¹, A. C. Valenzuela González¹

¹IMTSAG, Universidad Iberoamericana, Santo Domingo, Dominican Republic

Rationale: Although guideline-based nutritional screening and assessment is recommended, practice is variable, especially in middle-income settings, which may affect patient outcomes

Methods: A nationwide survey involving 32 nutritionists was carried out. The questionnaire investigated various aspects of nutrition support, including infrastructure, screening, assessment, and other points, as well as practices related to home enteral nutrition. Descriptive analyses were enhanced by odds ratios. We created a 13-point maturity index, based on practices that align with established guidelines. 

Results: Early screening was associated with structured nutritional assessment (OR 25.0; 95% CI 1.93-323.55; p=0.015). Institutional protocol use was associated with NRS-2002 use (OR 15.43; 95% CI 1.56-152.35; p=0.010). Multimodal muscle assessment was associated with a full response bundle (OR 7.29; 95% CI 1.17-45.25; p=0.038). The exploratory maturity index showed substantial heterogeneity (mean 9.53 ± 2.53, median 10, range 1-13; Cronbach alpha 0.73).

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Conclusion: Clinical nutrition services are structurally available in Dominican public hospitals but inconsistently implemented. Early screening, protocolization, and multimodal muscle assessment may increase quality. 

References: Cederholm, Tommy, et al. "GLIM criteria for the diagnosis of malnutrition: a consensus report from the global clinical nutrition community." Journal of cachexia, sarcopenia and muscle 10.1 (2019): 207-217. 

Singer, Pierre, et al. "ESPEN guideline on clinical nutrition in the intensive care unit." Clinical nutrition 38.1 (2019): 48-79. 

Disclosure of Interest: None declared