[ Vol. 8 No. 3 ] (September - December 2007 )
The differences of subjective global assessment between nurses and dietitians

Rie Furukawa, RD, Keiko Zama, RD, Atsuo Ohashi, RD, Fumiaki Katada, MD, MPH, CNSP*
Kameda Medical Center, Kamogawa. Japan


Background: A number of doctors, nurses, and dietitians are evaluating Subjective Global Assessment (SGA) every day. However, there are few studies reporting the tendency of assessment depending on their specialties.

Objective: To clarify the concordance proportion of SGA between nurses and dietitians, and to examine the tendency of assessment between them.

Setting: A tertiary emergency hospital in Chiba, Japan.

Methods: Consecutive patients who were newly admitted Kameda Medical Center in July 2007 were included. All patients were evaluated SGA by one nurse and one dietitian. They assessed SGA independently and the results were masked to each other. The concordance proportion of SGA between nurses and dietitians were calculated. When the SGA evaluation between nurses and dietitians disagree, the tendency of assessment of each SGA items depending on their specialties were assessed.

Results: During the study period, a total of 201 patients were evaluated. The concordance proportion of SGA was 82.1% (165/201). The concordance proportion of each SGA items was 80% or more, except for two items (Gastrointestinal symptoms 78.6%, Nutritional requirements 56.2%). The “disagree” cases were 17.9% (36/201). Among them, nurses evaluated SGA lower than dietitian in 12 cases, and SGA items related to “History” (e.g. gastrointestinal symptoms, Functional capacity) were tended to score lower by nurses. On the other hand, dietitians evaluated SGA lower than nurses in 24 cases, and SGA items related to “Physical” (e.g. Loss of subcutaneous fat, Muscle wasting) were tended to score lower by dietitians.

Conclusion: The concordance proportion of SGA was 82.1% between nurses and dietitians. When they disagree, nurses tended to think the patients’ history important, and dietitians tended to regard the patients’ physical important. To do a better assessment, it is important to consider each other’s viewpoint.

* Oral presentation

The 12th PENSA Congress
October 18-20 2007
Century Park Hotel, Manila, Philippines
Page: 51