EXPERIENCE REPORT ON THE ROLE OF A NUTRITIONIST RESIDENT IN GERIATRIC CARE AT A UNIVERSITY HOSPITAL

Abstract

Background: The multiprofessional health residency is a lato sensu postgraduate program designed to enhance professional qualification through specialization in comprehensive healthcare delivery within a multiprofessional team. In this context, the nutritionist’s role goes beyond the discipline-specific practices, fostering an interdisciplinary approach to patient care in collaboration with other professionals on the healthcare team. Purpose: To report the experiences of a nutritionist resident as part of a multiprofessional team, with an emphasis on geriatric hospital care in a university hospital setting. Methods: This qualitative study is structured as an experience report by a nutritionist participating in a multiprofessional residency program, with an emphasis on hospital-based care for older adults. The residency program comprises a total workload of 60 hours per week, amounting 5,760 hours over two years. Of this total, 4,608 hours (80%) are allocated to practical activities, while 1,152 hours (20%) are dedicated to theoretical or theoretical-practical training. The multiprofessional team involved in the program includes professionals from the fields of nutrition, psychology, nursing, pharmacy, physical therapy, speech therapy, social work, and occupational therapy. Results: During the practical training in geriatric care, the nutritionist resident engages in a range of activities, including the nutritional and anthropometric screening and assessment of elderly patients admitted to either general wards or intensive care units (ICUs). These hospitalizations are predominantly due to acute episodes or decompensations of chronic non-communicable diseases, such as diabetes mellitus, hypertension, nephropathies, cardiopathies, pneumonia and chronic obstructive pulmonary disease (COPD). Based on the clinical and dietary needs of each patient, the resident conducts nutritional follow-ups and reassessments on a daily or week basis. Nutritional therapy prescriptions include exclusive oral diets, oral supplementation (ONS), or enteral nutrition (EN) via the institution’s Nutritional Therapy Service (NTS), for patients at nutritional risk who require additional support, given the close association between nutritional status, clinical prognosis, and length of hospital stay. The resident also contributes to the management of patients receiving parenteral nutrition, in collaboration with the Multidisciplinary Nutritional Therapy Team (MNTT), which includes a nutritionist, physician, endocrinologist, nurse, and pharmacist. Additional activities include bedside visits with the team of resident professionals. Theoretical training involves weekly didactic sessions for all program participants, as well as nutrition-specific modules addressing topics pertinent to clinical practice. Furthermore, interdisciplinary meetings with the specialized geriatric care team are held to discuss patient cases and treatment strategies. These include the development of the Singular Therapeutic Project (STP), clinical case discussions and article discussions with supervising nutritionists. Conclusion: These experiences play a fundamental role in both personal and professional development. The multiprofessional residency program prioritizes practical, experience-based training, facilitates the transition into the workforce, and enhances the qualification healthcare professionals, thereby contributing to the strengthening of the health system as a whole.