The Integrated Nutrition Pathway for Acute Care (INPAC) is an evidence and consensus based pathway developed to guide health care professionals in the prevention, detection, and treatment of malnutrition in medical and surgical patients. From 2015 to 2017, the More-2-Eat implementation project (M2E) used a participatory action research approach to determine the feasibility, and evaluate the implementation of INPAC in 5 hospital units across Canada. Based on the findings of M2E and consensus with M2E stakeholders, updates have been made to INPAC to enhance feasibility in Canadian hospitals. The learnings from M2E have been converted into an online toolkit that outlines how to implement the key steps within INPAC. The aim of this short report is to highlight the updated version of INPAC, and introduce the implementation toolkit that was used to support practice improvements towards this standard.Electronic supplementary materialThe online version of this article (10.1186/s12937-017-0310-1) contains supplementary material, which is available to authorized users.
Background: Malnutrition is common in hospitalized patients and is associated with increased mortality, length of stay, and risk of re-admission. The consensus based Integrated Nutrition Pathway for Acute Care (INPAC) was developed and validated to enhance patients' nutrition care and improve clinical outcomes. As part of the More-2-Eat project (M2E), five hospitals implemented INPAC activities (e.g. screening) in a single medical unit. The purpose of this paper is to demonstrate the care gaps with respect to INPAC activities on these five units prior to implementation. Results were used as part of a needs assessment on each unit, demonstrating where nutrition care could be improved and tailoring of implementation was required.
It has been previously suggested that chronic care elderly patients are at increased nutritional risk. However dietary intake studies have not completely supported this statement. To determine usual dietary intakes, 32 elderly patients, mean (+/- SEM) age 84 +/- 1 years, from two hospitals, had 3-day dietary intakes estimated or weighed and analyzed for nutrient composition. The group as a whole had low intakes of dietary fibre but intakes of other nutrients were equal to or greater than the Canadian recommendations. The distribution of macronutrients also met recommended guidelines. In general, this group of elderly patients appeared to be eating well, however, some individuals results suggest nutritional risk.
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