New Hospital Malnutrition Standardized Guidelines
Hospital
Malnutrition Standardized Guidelines
Malnutrition remains a serious
problem in hospitals today. It is estimated that one in three patients enter
the hospital malnourished and if left untreated will experience significant
decline in their condition. It is also estimated that one in three patients
becomes malnourished during their hospital stay which severely compromises
their short and long term outcomes. Malnutrition contributes to pressure
ulcers, poor wound healing, infection, longer hospital stays, and readmissions
which all create higher health care costs.
These serious consequences of
malnutrition have led dietitians to improve nutritional assessments and allot
more time to spend monitoring malnourished or at-risk patients. With current
policy changes in our healthcare system promoting affordable care, there is a
need to emphasize the role that nutrition therapy plays in patient care. Five
organizations have launched a partnership to improve patient outcomes through
nutrition intervention in hospital settings. These organizations include the
Academy of Medical-Surgical Nurses, The Academy of Nutrition and Dietetics, the
American Society for Parenteral and Enteral Nutrition, The Society of Hospital
Medicine, and Abbott Nutrition.
These parties have worked together to
establish a more standardized guideline for diagnosing malnutrition in order to
deliver quality, time-sensitive care. It has been proposed that malnutrition be
diagnosed from six characteristics including: insufficient energy intake,
weight loss, body fat loss, muscle mass loss, fluid accumulation, and reduced
grip strength. When two or more of these criteria are met, malnutrition may be
diagnosed.
The alliance has also formed six key
principles for clinicians to use in providing optimal nutrition care. These
involve collaboration with the entire health care team to provide well-rounded
and complete care. The alliance draws attention at the clinician’s
responsibility to create an hospital culture in which nutrition care is a top
priority. Other key principles include continues monitoring of nutrition
interventions, communicating care plans effectively and developing solid nutrition
plans for patients after they are discharged.
To both prevent and treat
malnutrition appropriately, dietitians can take several action steps. These
include working with nursing to ensure nutrition screening is properly
performed, implementing nutrition-focused physical assessment into the
facility, using the new standardized malnutrition guidelines to diagnose
malnutrition, and being an active and visible member of the healthcare team.
Corrigan ML. Hospital
malnutrition – standardized guidelines take center stage. Today’s Dietitian.
2014:16(1);40.
Tappenden KA, Quatrara B, Parkhurst ML, Malone AM, Fanjiang G,
Ziegler TR. Critical role of nutrition in improving quality of care: an
interdisciplinary call to action to address adult hospital malnutrition. J Parenter Enteral Nutr.
2013;37(4):482-497.
View article at: http://www.todaysdietitian.com/newarchives/010614p40.shtml
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