Vitamin and Mineral Supplementation Practices in Preterm Infants: A Survey of Australian and New Zealand Neonatal Intensive and Special Care Units.

Preterm infants are at increased risk of micronutrient deficiencies as a result of low body stores, maternal deficiencies, and inadequate supplementations. The aim of this survey was to investigate current vitamin and mineral supplementation practices and compare these with published recommendations and available evidence on dosages and long-term outcomes of supplementations in preterm infants. In 2018, a two-part electronic survey was emailed to 50 Australasian Neonatal Dietitians Network (ANDiN) member and nonmember dietitians working in neonatal units in Australia and New Zealand. For inpatients, all units prescribed between 400 and 500 IU/day vitamin D, compared to a recommended intake range of 400-1000 IU/day. Two units prescribed 900-1000 IU/day at discharge. For iron, 83% of respondents prescribed within the recommended intake range of 2-3 mg/kg/day for inpatients. Up to 10% of units prescribed 6 mg/kg/day for inpatients and at discharge. More than one-third of units reported routine supplementations of other micronutrients, including calcium, phosphate, vitamin E, and folic acid. There was significant variation between neonatal units in vitamin and mineral supplementation practices, which may contribute to certain micronutrient intakes above or below recommended ranges for gestational ages or birth weights. The variations in practice are in part due to differences in recommended vitamin and mineral intakes between expert groups and a lack of evidence supporting the recommendations for supplementations.

A dietetic clinical educator enhances the experience and assessment of clinical placement.

AIM: The aim of this study was to evaluate the impact of a Clinical Educator model on the learning experience and environment for students, preceptors and managers. METHODS: A Clinical Educator position was established for the 10-week dietetic clinical placement at Edith Cowan University. The Clinical Educator was responsible for overseeing the placement and assisting in the supervision of students. A qualitative descriptive approach using focus groups with purposive sampling explored the research question. Students (n = 10), preceptors (n = 21) and managers (n = 3) participated in separate focus groups. Data were thematically analysed with consideration given to participant and focus group commonalities and differences. RESULTS: The findings revealed that the Clinical Educator (i) reduced the logistical burden of student placements and improved time efficiency; (ii) facilitated student assessment within a programme of assessment; (iii) was uniquely positioned to provide support and enhance student confidence; and (iv) enhanced capacity to manage underperforming and challenging students. CONCLUSIONS: The Clinical Educator model increased student confidence, facilitated quality assessment and supported the management of underperforming students. This was achieved by reducing the burden of clinical placements, facilitating effective and timely communication between stakeholders and supporting the establishment of meaningful relationships which enriched learning. The results highlight the importance of the people involved in placement to facilitate a positive student learning environment and high quality assessment.