Establishment of a nutritional management system through appointment of full-time dietitians in a gynecological ward and its practical effectiveness

• Published in: Journal of the Japan Dietetic Association Vol. 68; no. 3; pp. 161 - 167
• Main Authors: Ito, Akemi, Harada, Ayumi
• Format: Journal Article
• Language: Japanese
• Published: The Japan Dietetic Association 2025; 公益社団法人 日本栄養士会
• Subjects: addition of an inpatient nutrition management system; full-time registered dietitians; task shifting and task sharing; タスクシフト・タスクシェア; 入院栄養管理体制加算; 専従管理栄養士
• ISSN: 0013-6492; 2185-6877
• DOI: 10.11379/jjda.68.161

Given the revision of the medical service fee in the fiscal year 2022, a new inpatient nutritional management system with an additional 270 points (on the first day of hospitalization and at the time of discharge) was established by the Ministry. The requirements include the placement of a full-time registered dietitian in each ward to provide patients with detailed nutritional management. To meet the requirements for medical service fees in the gynecology ward, our hospital has established a nutrition management system in a dedicated staffing ward, incorporating interviews during admission and meal rounds. Patients requiring intervention were more likely to have advanced cancer and were more likely to be malnourished or at risk of malnutrition on admission. Our findings have suggested that energy and protein sufficiency rates could be improved in these patients when a dedicated dietitian selects appropriate dietary content and nutritional supplements on admission and conducts regular monitoring. The system has also enabled seamless nutritional management from hospitalization to outpatient care, including providing nutritional guidance at discharge. It was also inferred that having a registered dietitian actively make dietary adjustments to accommodate allergies and chewing and swallowing functions could be useful for task-shifting and task-sharing with doctors and nurses.