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The Role of a Nutrition Support Team: a “best practice” in clinical nutrition1,2

Parenteral nutrition is the intravenous (IV) delivery of nutrients to critically and chronically ill patients who cannot eat by mouth or obtain enough nutrients through enteral nutrition alone. It can be a complicated process that requires an integrated team effort to ensure safe and effective delivery. Enter the Nutrition Support Team (NST). An NST is a multidisciplinary team made up of several healthcare professionals who work together to help meet the nutritional needs of their patients in many settings, including hospitals, long-term care facilities, and homes. Who are these healthcare professionals and what roles do each of them play in delivering nutrition support? Keep reading to find out.

“[An] NST has a central role in the management of patients with complex nutritional therapy in the inpatient and outpatient setting, during the hospital stay and beyond.”3

Physicians, dietitians, pharmacists, and nurses make up the Nutrition Support Team4,5:

  • Physicians most often lead the Nutrition Support Team. They must communicate with other members of the team and “engage in all aspects of direct care of patients’ nutritional needs.”4 They should be familiar with their patient’s nutritional status to provide the best care possible. In addition, they are responsible for writing an appropriate PN prescription.

  • Dietitians perform assessments to determine each patient’s individual nutritional needs. Once the assessment is complete, they communicate with the physician and recommend a customized nutrition care plan for their patient.

  • Pharmacists are integral members of the Nutrition Support Team in that they help improve the quality of care by making treatment and dosing recommendations and providing education to other healthcare professionals, patients, families, and caregivers. They are responsible for verifying and compounding PN orders, ensuring that the PN formula is appropriate and that the ingredients are compatible. In addition, they must make sure that PN solutions are properly labeled, delivered, and stored.

  • Nurses provide direct patient care. They obtain IV access and administer PN to their patients while maintaining infection control. They also monitor their patients and communicate any changes to the physicians who are managing their patients’ nutritional care. In addition, nurses provide education to patients and their families or caregivers.

“The key task of NSTs is to implement a comprehensive nutritional care system, so that every patient who could potentially benefit from nutritional support receives it rapidly, adequately, and with the highest standards of quality.”3


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References: 1. Durfee SM, Adams SC, Arthur E, et al. A.S.P.E.N. Standards for Nutrition Support: Home and Alternate Site Care. Nutr Clin Pract. 2014;29(4):542-555. 2. Ukleja A, Gilbert K, Mogensen KM, et al. Standards for Nutrition Support: Adult Hospitalized Patients. Nutr Clin Pract. 2018;33(6):906-920. 3. Reber E, Strahm R, Bally L, Schuetz P, Stanga Z. Efficacy and Efficiency of Nutritional Support Teams. J Clin Med. 2019;8(9):1281. Published 2019 Aug 22. 4. What Is a Nutrition Support Professional?. ASPEN website. https://www.nutritioncare.org/what-is-a-NSP/. Accessed June 1, 2022. 5. Boullata JI. Overview of the parenteral nutrition use process. JPEN J Parenter Enteral Nutr. 2012;36(2 Suppl):10S-13S.