New Dietary Guidlines?

[hppygr8ful, ASN, RN, EMT-I]

So yesterday I was at work when an inservice was called by the Registered Dietician. She told us that under ACA (Affordable Care Act) patiens in hospitals would now only be able to be placed on one therapeutic diet. Texture considerations go first so if say a Cardiac patient has a pureed diet they cannot also have a low sodium or low fat diet. The diet instructions are to read Reg Diet (pureed) omit salt packet, omit added fat.

The dietician stated that there was new research that restricted diets actually have little impact on over all health. While I tend to agree I have been looking for good peer reviewed research to back up this claim. Has anyone else heard this?

Hppy

[Rose_Queen, BSN, MSN, RN]

I would not be surprised to find that the ACA is once again being blamed for something it's not responsible for or that someone is misinterpreting.

Edit: Top Google results for "ACA and nutrition" take me to either the American Chiropractic Association results or sites explaining requirements of restaurants to provide nutritional information.

[dudette10, MSN, RN]

Ask the dietitian for copies of the research on restricted diets.

And, I never take the word of anyone when they mention the ACA--I look it up myself. When one of the QI nurses (someone who really should know) was claiming that we don't get reimbursed for individual patient stays when they are readmitted, I give up on people actually knowing what the ACA requires.

For the record, reimbursement is reduced by a certain percentage based on the number of readmissions over an expected amount. That does NOT mean if Mrs. Smith is readmitted, we have to eat the cost of her specific stay.

[Libby1987]

Nearly every conscientious diabetic I have complains of the high carb meals they were served in the hospital. Though they were usually no salt.. Sometimes they have family bring in appropriate food. I really don't get it.

[Libby1987]

I definitely agree about texture being the priority, but after that it often doesn't make sense anyway. What is the point of getting someone stable on a diet they aren't going to follow at home? They go from no salt to realistic or worse almost everytime. I would appreciate getting their fluid balanced based on a diet the patient is realistically going to follow.

OR they're on a no salt diet in the hospital discharged home on a regular diet. Hear that one a lot.

[KelRN215, BSN, RN]

I'm with Rose_Queen on this, what would this have to do with the ACA? When I Google Affordable Care Act and hospital diets, I find links about hospitals that are supporting healthy nutrition programs in the community. Plus what difference does it make if the diet reads "puree diet, low fat diet, low salt diet" or "puree diet, no added salt or fat." Sounds like the same thing to me.

[dirtyhippiegirl, BSN, RN]

Yeah. It's all over the news -- re. cholesterol intake not having an appreciable effect on heart health and salt consumption not actually linked to hypertension except possibly in some african american populations. I googled "cholesterol and new dietary guidelines" and found a lot of articles that will probably lead back to the source. I am sure you will find the same for salt.