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Journal of Pediatric Psychology Advance Access published online on May 6, 2009
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsp029
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© The Author 2009. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Description of a standardized nutrition classification plan and its relation to nutritional outcomes in children with cystic fibrosis

Amanda Leonard, MPH, RD, CDE1, Erin Davis, RD, CNSD1, Beryl J. Rosenstein, MD2, Pamela L. Zeitlin, MD, PhD2, Shruti M. Paranjape, MD2, Donna Peeler, RN2, Cynthia Maynard, PhD3 and Peter J. Mogayzel, Jr, MD, PhD2

1Division of Pediatric Gastroenterology and Nutrition, 2Eudowood Division of Pediatric Respiratory Sciences, The Johns Hopkins Medical Institutions, 3Department of Behavioral Psychology, Kennedy Krieger Institute

All correspondence concerning this article should be addressed to Peter J. Mogayzel, Jr, MD, PhD, Cystic Fibrosis Center, The Johns Hopkins Hospital, 200 North Wolfe Street, Baltimore, MD 21287-2533, USA. E-mail: pmogayze{at}jhmi.edu


  Abstract

Objective Better nutrition enhances lung function and increases survival for children with cystic fibrosis (CF). Therefore, we developed a standardized strategy to evaluate nutritional status and create individualized treatment plans to ensure that all patients received the same high-quality care in a busy CF Center. Methods A quality improvement approach was undertaken to develop a novel nutrition classification strategy to identify and treat children with subtle manifestations of nutritional deficits in addition to those with obvious nutritional issues. Results During the 15-month study period, the median body mass index (BMI) percentile increased from 35.2 (0–95.9) to 42.0 (0–97.7), p < .005. Additionally, the number of children with a BMI ≥ 50th percentile increased by 11.8%. Conclusions Adoption of a standardized approach to nutritional assessment and treatment led to significant improvement in nutritional outcomes of CF patients, demonstrating that systematic changes in clinical practice can improve clinical outcomes substantially over a short period of time.

Key words: cystic fibrosis; nutrition; quality improvement..

Received July 22, 2008; revision received March 20, 2009; accepted March 20, 2009


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