Diagnosis and treatment of (disease-related) in-hospital malnutrition: The performance of medical and nursing staff

Bavelaar, J.W.; Otter, C.D.; Bodegraven, Adriaan A. van; Thijs, Abel; Schueren, Marian A.E. de van der

doi:10.1016/j.clnu.2008.01.016

Cited by 91 publications

(85 citation statements)

References 22 publications

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“…Although 430 years passed since Butterworth introduced the concept of 'iatrogenic malnutrition' (worsening of nutritional status during the hospital stay due to the lack of adequate nutritional support) (Butterworth, 1974), it seems likely that disease-related malnutrition still goes underdiagnosed and undertreated. The results from the present survey agree with those previously obtained in other countries and highlight that the lack of knowledge, interest and responsibility and the difficulties in making a nutrition plan are clearly the target for future improvements (Mowe et al, 2006;Singh et al, 2006;Bavelaar et al, 2008). The consequence is the deterioration of nutritional status.…”

Section: Discussionsupporting

confidence: 82%

“…Despite the prognostic role of diseaserelated malnutrition in negatively affecting the patient's outcome (mortality, morbidity, length of stay (LOS), healthcare costs, functional status and quality of life), recent surveys suggest that nutritional care routines by healthcare professionals are still poor (Mowe et al, 2006;Singh et al, 2006;Bavelaar et al, 2008). As a consequence, the nutritional status of the patient may even worsen during the hospital stay with patients experiencing further weight loss and a slower recovery (McWhirter and Pennington, 1994;Norman et al, 2008;Cansado et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

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Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study

Cereda

Lucchin

Pedrolli³

et al. 2010

Eur J Clin Nutr

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Background/Objectives: Disease-related malnutrition is a common comorbidity at hospital admission. The purpose of the present report was to describe the data on nutritional care routines collected during the Project: Iatrogenic MAlnutrition in Italy (PIMAI) study, as these may be helpful to avoid iatrogenic malnutrition and improve nutritional policies. Subjects/Methods: Standards of nutritional care were assessed on the basis of (1) adherence to study protocol (completeness of data collected); (2) attitude in assessing the nutritional status; (3) prescription of nutritional therapy (within 3 days) at least in patients presenting with overt malnutrition (body mass index (BMI) o18.5 kg/m 2 or significant weight loss (X10% in 3 months and/or X5% in the last month)), regardless of its adequacy, and adherence to current guidelines and (4) attitude in monitoring nutritional status during the stay (number of weight measurements performed compared with those expected). Results: In total, 1583 subjects were assessed. A minimum data set for performing the Nutritional Risk Screening 2002 tool was available in 1284 patients (81.1%), but nutritional screening was possible in every patient by alternative analytical criteria related to food intake, anthropometry and biochemistry. However, several missing values were recorded, particularly in biochemical parameters due to lack of prescription by admission wards. According to ward practices, only 38.2% of the patients had the BMI calculated. A nutritional support was prescribed only to 26/191 patients (13.6%) presenting with overt malnutrition. Finally, we recorded that only 21.6% of the patients (207/960 were randomly selected) had their weight monitored on a scheduled basis. This reality was worse in surgical rather than medical departments (17 vs 26%; Po0.001). Conclusion: Present results confirm that in Italy, nutritional care routines are still poor and need improvements.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study

Cereda

Lucchin

Pedrolli³

et al. 2010

Eur J Clin Nutr

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“…It has been studied worldwide [1,2] and despite increasing awareness it still goes undiagnosed and undertreated [3]. It seems that clinicians are much more interested in describing the dimension of the problem than in coping with it.…”

mentioning

confidence: 99%

“…It seems that clinicians are much more interested in describing the dimension of the problem than in coping with it. Along with this, recent studies focusing on current clinical practice point out poor nutritional routines and attitudes among healthcare professionals [3,4].…”

mentioning

confidence: 99%

Fighting hospital malnutrition: let’s start by calibrating hospital scales!

Pedrolli¹,

Cereda

Costa³

2009

Mediterr J Nutr Metab

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Body weight measurement is fundamental in nutritional screening. Thus, weighing scales should be regularly calibrated. This procedure is so important that in 1990 the Council of Europe produced an ad hoc directive. Unfortunately, little is known about scales management in hospitals. We performed an inventory in the City Hospital of Trento (~900 beds), which is responsible for the healthcare of ~250,000 inhabitants. The analysis included flat, chair and paediatric neonatal scales. We focused attention on the date of arrival and calibration management. In the hospital, there were 211 scales: 190 flat scales, 13 chair scales and 8 paediatric neonatal scales. The mean "age" was 10.3±7.3 years; 22.3% were 5-10 years old and 44.1% were aged >10 years. No scale was ever calibrated. They are managed by the "Internal Logistics Unit", meaning that scales are regarded as pieces of furniture rather than as diagnostic tools.Accurate weight measurement is a key task in nutritional management. However, our results once highlight limitations in this process. It is not enough to design laws and accreditation standards for the European Community; enforcement should be also checked.

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“…Despite the availability of malnutrition screening tools, 9 such as the Nutritional Risk Screening (NRS-2002) instrument, 10 malnutrition continues to be underrecognized. [11][12][13] Multiple definitions for malnutrition can be found, and no standards exist for standardization in documenting malnutrition nutritional information. In response, the Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition jointly released a consensus statement in 2012 outlining recommendations for the detection and documentation of malnutrition in adults.…”

mentioning

confidence: 99%

New Guidelines for Assessment of Malnutrition in Adults: Obese Critically Ill Patients

Mauldin

O’Leary-Kelley

2015

Critical Care Nurse

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Recently released recommendations for detection and documentation of malnutrition in adults in clinical practice define 3 types of malnutrition: starvation related, acute disease or injury related, and chronic disease related. The first 2 are more easily recognized, but the third may be more often unnoticed, particularly in obese patients. Critical care patients tend to be at high risk for malnutrition and thus require a thorough nutritional assessment. Compared with patients of earlier times, intensive care unit patients today tend to be older, have more complex medical and comorbid conditions, and often are obese. Missed or delayed detection of malnutrition in these patients may contribute to increases in hospital morbidity and longer hospital stays. Critical care nurses are in a prime position to screen patients at risk for malnutrition and to work with members of the interprofessional team in implementing nutritional intervention plans.

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Diagnosis and treatment of (disease-related) in-hospital malnutrition: The performance of medical and nursing staff

Cited by 91 publications

References 22 publications

Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study

Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study

Fighting hospital malnutrition: let’s start by calibrating hospital scales!

New Guidelines for Assessment of Malnutrition in Adults: Obese Critically Ill Patients

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