Depression Screening Among African American Adults in the Primary Care Setting.

Although depression is treatable with medication and psychotherapy, it is often left undiagnosed or misdiagnosed in African American communities. African American patients may experience poor outcomes when medical problems coexist with undiagnosed and untreated mental health issues, such as depression. This is a concern because depression can inhibit compliance with providers' treatment plans. A major factor in treatment of depression is assessment and recognition of the condition itself so that a proper diagnosis and treatment plan can be determined. The purpose of the current study was to examine the effects of a depression screening tool on depression diagnoses and treatment initiation in African American patients in a primary care setting. In 200 patients prior to screening implementaion, none were screened or diagnosed with depression. After routine implementation of a depression screening tool, 75 of 182 patients were diagnosed with depression. Using a routine screening tool resulted in a 41% increase in diagnoses of depression. The integration of routine depression screening in the primary care setting may improve overall health outcomes and competence in implementation of care. [Journal of Psychosocial Nursing and Mental Health Services, 57(10), 18-23.].

Comparison of Microbial Growth Between Commercial Formula and Blenderized Food for Tube Feeding.

BACKGROUND: Many healthcare facilities and providers prohibit blenderized tube feeding (BTF) for patients who request it due to concerns of high microbial load. The current project compared microbial loads of a standard ready-to-feed polymeric commercial formula (CF), a BTF made using baby food (BTF-BF), and a BTF prepared from blending whole food (BTF-WF), following food safety standards expected of U.S. hospitals. METHODS: Three tube-feeding formulas (CF, BTF-BF, BTF-WF) were prepared in a U.S. hospital and delivered in vitro to an unoccupied patient room. Samples were collected at zero hour, 2 hours, and 4 hours and compared for growth of aerobic microorganisms, Staphylococus aureus, coliforms, and Escherichia coli. The experiment was conducted in triplicate, 1 week apart. RESULTS: No S. aureus or coliform/E. coli were detected at any time point following preparation, and total bacterial count was well below acceptable limits. All 3 feeding formulas at zero hour, 2 hours, and 4 hours for each of the 3 sampling dates were acceptable for human consumption. CONCLUSION: Judicious BTF recipe selection and adherence to safe food handling provide a safe feeding substrate equivalent to CF in the hospital setting. Due to increased use and interest in BTF by patients and their caregivers, healthcare facilities may need to reexamine their policies prohibiting BTF use.

Reemergence of Blended Tube Feeding and Parent's Reported Experiences in Their Tube Fed Children.

OBJECTIVE: Healthcare providers (HCPs) report increased interest in blenderized tube feeding (BTF) as an alternative to commercial formula (CF) feeding-particularly in families of tube fed children. The objective of this study was to explore parents' reported experiences of CF and BTF in their children. DESIGN: Prospective descriptive study utilizing a convenience sample. SETTING/SUBJECTS: Parents (n = 433) of tube fed children in an online tube feeding support group completed an electronic survey to compare experiences of CF and BTF in their tube fed children. RESULTS: The sample was evenly represented by parents using CF (50.5%) and BTF (49.5%). Reasons parents chose BTF included desire to provide whole foods (20.2%), decrease symptoms of tube feeding intolerance (19.7%), provide family meals (12.2%), increase oral intake (10.8%), address allergies (5.3%), or because they did not like formula (19.7%). Parents reported fewer symptoms of tube feeding intolerance on BTF and their children more frequently met growth goals compared to formula feeding. Only half (49.3%) of parents using BTF referred to HCPs for recipes and feeding oversight. The primary reasons parents did not use BTF included lack of knowledge (50.9%) or time constraints (20.0%). CONCLUSIONS: A significant number of parents in this sample successfully provide full or partial BTF to their children but only half rely on HCPs for guidance. There is wide variability in BTF preparation and delivery. Parents who use or have interest in BTF need knowledgeable and supportive HCPs for guidance and follow-up due to the unique nutritional needs of this patient population. HCPs need to be prepared to screen families of tube fed children who are using BTF or are interested in this feeding alternative to CF. Healthcare facilities need to evaluate their enteral feeding policies to accommodate patients on BTF.