Critical Role of Nutrition in Improving Quality of Care

Abstract

The current era of healthcare delivery, with its focus on providing high-quality, affordable care, presents many challenges to hospital-based health professionals. The prevention and treatment of hospital malnutrition offer a tremendous opportunity to optimize the overall quality of patient care, improve clinical outcomes, and reduce costs. Unfortunately, malnutrition continues to go unrecognized and untreated in many hospitalized patients. This article represents a call to action from the interdisciplinary Alliance to Advance Patient Nutrition to highlight the critical role of nutrition intervention in clinical care and to suggest practical ways to promptly diagnose and treat malnourished patients and those at risk for malnutrition. We underscore the importance of an interdisciplinary approach to addressing malnutrition both in the hospital and in the acute posthospital phase. It is well recognized that malnutrition is associated with adverse clinical outcomes. Although data vary across studies, available evidence shows that early nutrition intervention can reduce complication rates, length of hospital stay, readmission rates, mortality, and cost of care. The key is to systematically identify patients who are malnourished or at risk and to promptly intervene. We present a novel care model to drive improvement, emphasizing the following 6 principles: (1) create an institutional culture where all stakeholders value nutrition, (2) redefine clinicians' roles to include nutrition care, (3) recognize and diagnose all malnourished patients and those at risk, (4) rapidly implement comprehensive nutrition interventions and continued monitoring, (5) communicate nutrition care plans, and (6) develop a comprehensive discharge nutrition care and education plan.

Changing nutrition care practices in hospital: a thematic analysis of hospital staff perspectives

“…However, the clinical importance of adequate nutrition care and its impact on patient-centred care is recognized but not always acted upon [14, 15, 25, 26]. Raising awareness and providing education about the issue is important, but it is not enough.…”

“…For improving nutrition care practices, dietitians cannot do this alone. Dietitians should work as part of an interdisciplinary team to effect beneficial changes in nutrition care for all patients [15]. …”

“…Few studies have attempted to describe how to improve hospital nutrition care practices and embed those practices in the unit routine [13]. An interdisciplinary approach is needed to improve the prevention, detection and treatment of hospital malnutrition [14, 15]. A key component of changing practice is to understand the views of those who will be involved in the change and the context or climate where the changes are occurring [16, 17].…”

Quality Nutrition Care: Measuring Hospital Staff’s Knowledge, Attitudes, and Practices

“…As approximately 20%–50% of patients in acute care are malnourished [2,3] effective strategies to address this significant problem are needed. In 2013, the Alliance to Advance Patient Nutrition published a call to action for improving nutrition care in hospitals [7], which suggested that a comprehensive approach involving all staff was needed [2,8,9]. In response, a consensus based Integrated Nutrition Pathway for Acute Care (INPAC) was developed [10].…”

The Critical Theoretical Perspectives and the Health Care System

“…Classifications reflect distinctions inherent in the world, assume determinism (Polit & Beck, 2012), and facilitate predictions. Traditionally theories and scientific knowledge are produced within a discipline, until it was proven that interdisciplinary coercion provides a more sophisticated knowledge and allow a better understanding of complex reality (Kim 2000;Peter et al, 2011;Tappenden et al 2013;Tjora & Melby, 2013). Interdisciplinary health research is increasingly encouraged and is often a specific requirement for research grants worldwide (Clarke, Hawkins, Sadler, et al, 2012).…”