Reducing the knowledge to action gap in hospital nutrition care – Developing and implementing nutritionDay 2.0

Moick, S.; Hiesmayr, M.; Mouhieddine, M.; Kiss, Noemi; Bauer, Péter; Sulz, Isabella; Singer, Pierre; Simon, Judit

doi:10.1016/j.clnu.2020.06.021

Cited by 11 publications

(10 citation statements)

References 37 publications

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“…Such gaps can be initially addressed by increasing awareness of the importance of nutrition for patients and caregivers alike. Importantly, a new 2.0 version of nDay has been developed and is now being tested for its effectiveness in promoting behavioral and practice changes that can improve patient outcomes based on better hospital nutrition care practices [46]. An ever-growing number of hospital-based quality improvement programs (QIPs) have demonstrated how nutrition interventions are clearly associated with improved patient outcomes (eg, reduced hospital length of stay, rehospitalizations, complications, etc.)…”

Section: Discussionmentioning

confidence: 99%

Prevalence of malnutrition risk and its association with mortality: nutritionDay Latin America survey results

et al. 2021

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Background & aims: Across the globe, the prevalence of hospital malnutrition varies greatly depending on the population served and on local socioeconomic conditions. While malnutrition is widely recognized to worsen patient outcomes and add financial burdens to healthcare systems, recent data on hospital malnutrition in Latin America are limited. Our study objectives were: (1) to quantify the prevalence of malnutrition risk in Latin American hospital wards, and (2) to explore associations between nutritional risk status, in-hospital food intake, and health outcomes. Methods: On nutritionDay (nDay), a specific day every year, hospital wards worldwide can participate in a one-day, cross-sectional audit. We analyzed nDay data collected in ten Latin American countries from 2009 to 2015, including demographic and nutrition-related findings for adult patients (18 years) from 582 hospital wards/units. Based on patient-reported responses to questions related to the Malnutrition Screening Tool, we determined the prevalence of malnutrition risk (MST score 2). We also summarized patient-reported food intake on nDay, and we analyzed staff-collected outcome data at 30 days post-nDay. Results: The prevalence of malnutrition risk in the Latin American nDay study population (N ¼ 14,515) was 39.6%. More than 50% of studied patients ate one-half or less of their hospital meal, ate less than normal in the week before nDay, or experienced weight loss in the prior three months. The hospitalmortality hazard ratio was 3.63 (95% CI [2.71, 4.88]; P < 0.001) for patients eating one-quarter of their meal (compared with those who ate the full meal), increasing to 6.6 (95% CI [5.02, 8.7]; P < 0.0001) for patients who ate none of the food offered. Conclusions: Based on compilation of nDay surveys throughout Latin America, 2 of every 5 hospitalized patients were at risk for malnutrition. The associated risk for hospital mortality was up to 6-fold higher among patients who ate little or none of their meal on nDay. This high prevalence showed scant improvement over rates two decades agoda compelling rationale for new focus on nutrition education and training of professionals in acute care settings.

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Section: Discussionmentioning

confidence: 99%

Prevalence of malnutrition risk and its association with mortality: nutritionDay Latin America survey results

et al. 2021

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“…For this study, we used the Colombian, Latin American, and worldwide data from 2009 to 2015. Data after 2015 were not included because the questionnaire was modified after that 22 . The data were collected using 4 official nutritionDay questionnaires processed by voluntary healthcare professionals and students.…”

Section: Methodsmentioning

confidence: 99%

Are traditional screening tools adequate for monitoring the nutrition risk of in‐hospital patients? An analysis of the nutritionDay database

Cárdenas

Bermúdez

Pérez

et al. 2021

J Parenter Enteral Nutr

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Background Monitoring of adequate food intake is not a priority in hospital patients' care. The present study aimed to examine selective data from the nutritionDay survey to determine the impact of food intake during hospitalization on outcomes according to the nutrition risk status. Methods We conducted a descriptive analysis of selected data from 7 consecutive, annual, and cross‐sectional nutritionDay samples from 2009 to 2015. The impact of food intake on outcomes was assessed by univariate and multivariate Cox models controlling for PANDORA scores. Results A total of 7994 adult patients from Colombia, 7243 patients from 9 Latin American countries, and 155,524 patients worldwid were included. Less than half of the patients worldwide consumed their entire meal on nutritionDay (41%). The number of reduced eaters is larger in the “no nutrition risk group” than in the “nutrition risk group” (30% vs 25%). Reduced eating is associated with higher mortality and delayed discharge in patients, regardless of the nutrition risk status. Patients without nutrition risk at the screening who ate “nothing, but were allowed to eat” had 6 times more risk of mortality (hazard ratio, 6.48; 95% CI, 3.5311.87). Conclusions This is the first large‐scale study evaluating the relationship of food intake on clinical outcomes showing an increase of in‐hospital mortality rates and a reduction in the probability of being discharged home regardless of the nutrition risk status. Traditional screening tools may not identify a group of patients who will become at risk because of reduced intake while in the hospital.

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“…When patients are discharged to the hospital wards from ICU, they continue to be at risk of malnutrition as a result of patient (lack of appetite, absence of taste or smell sensations, impaired swallowing, lack of activity), structural (staff training, meal documentation) and process (meal timing and delivery) factors [30,31]. Several of these factors may be addressable with staff awareness and education, but must be explicitly looked for and managed.…”

Section: Recovery: In Hospitalmentioning

confidence: 99%

Nutritional priorities in patients with severe COVID-19

Puthucheary

Rice

2022

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of reviewThe COVID-19 pandemic has altered the profile of critical care services internationally, as professionals around the globe have struggled to rise to the unprecedented challenge faced, both in terms of individual patient management and the sheer volume of patients that require treatment and management in intensive care. This review article sets out key priorities in nutritional interventions during the patient journey, both in the acute and recovery phases. Recent findingsThe current review covers the care of the acutely unwell patient, and the evidence base for nutritional interventions in the COVID-19 population. One of the biggest differences in caring for critically ill patients with acute respiratory failure from COVID-19 is often the time prior to intubation. This represents specific nutritional challenges, as does nursing patients in the prone position or in the setting of limited resources. This article goes on to discuss nutritional support for COVID-19 sufferers as they transition through hospital wards and into the community.

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Reducing the knowledge to action gap in hospital nutrition care – Developing and implementing nutritionDay 2.0

Cited by 11 publications

References 37 publications

Prevalence of malnutrition risk and its association with mortality: nutritionDay Latin America survey results

Prevalence of malnutrition risk and its association with mortality: nutritionDay Latin America survey results

Are traditional screening tools adequate for monitoring the nutrition risk of in‐hospital patients? An analysis of the nutritionDay database

Nutritional priorities in patients with severe COVID-19

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