The Use of Technology in Identifying Hospital Malnutrition: Scoping Review

Abstract

BackgroundMalnutrition is a condition most commonly arising from the inadequate consumption of nutrients necessary to maintain physiological health and is associated with the development of cardiovascular disease, osteoporosis, and sarcopenia. Malnutrition occurring in the hospital setting is caused by insufficient monitoring, identification, and assessment efforts. Furthermore, the ability of health care workers to identify and recognize malnourished patients is suboptimal. Therefore, interventions focusing on the identification and treatment of malnutrition are valuable, as they reduce the risks and rates of malnutrition within hospitals. Technology may be a particularly useful ally in identifying malnutrition due to scalability, timeliness, and effectiveness. In an effort to explore the issue, this scoping review synthesized the availability of technological tools to detect and identify hospital malnutrition.ObjectiveOur objective was to conduct a scoping review of the different forms of technology used in addressing malnutrition among adults admitted to hospital to (1) identify the extent of the published literature on this topic, (2) describe key findings, and (3) identify outcomes.MethodsWe designed and implemented a search strategy in 3 databases (PubMed, Scopus, and CINAHL). We completed a descriptive numerical summary and analyzed study characteristics. One reviewer independently extracted data from the databases.ResultsWe retrieved and reviewed a total of 21 articles. We categorized articles by the computerized tool or app type: malnutrition assessment (n=15), food intake monitoring (n=5), or both (n=1). Within those categories, we subcategorized the different technologies as either hardware (n=4), software (n=13), or both (n=4). An additional subcategory under software was cloud-based apps (n=1). Malnutrition in the acute hospital setting was largely an unrecognized problem, owing to insufficient monitoring, identification, and initial assessments of identifying both patients who are already malnourished and those who are at risk of malnourishment. Studies went on to examine the effectiveness of health care workers (nurses and doctors) with a knowledge base focused on clinical care and their ability to accurately and consistently identify malnourished geriatric patients within that setting.ConclusionsMost articles reported effectiveness in accurately increasing malnutrition detection and awareness. Computerized tools and apps may also help reduce health care workers’ workload and time spent assessing patients for malnutrition. Hospitals may also benefit from implementing malnutrition technology through observing decreased length of stay, along with decreased foregone costs related to missing malnutrition diagnoses. It is beneficial to study the impact of these technologies to examine possible areas of improvement. A future systematic review would further contribute to the evidence and effectiveness of the use of technologies in assessing and monitoring hospital malnutrition.

Barriers and Facilitators for Implementing a Decision Support System to Prevent and Treat Disease-Related Malnutrition in a Hospital Setting: Qualitative Study

“…This corresponds with results from Eide et al [14]. A recent scoping review on the use of technology to identify hospital malnutrition revealed malnutrition in the acute hospital setting to largely be an unrecognized problem, owing to insufficient monitoring, identification, and assessment of malnourished patients [18]. We emphasized a general tension for changing nutritional care practice among all the health care professional groups investigated.…”

“…Studies have shown that hospitals can benefit from implementing technology to identify, handle, and follow up with patients at risk of malnutrition. Digital tools and apps may reduce the workload of health care professionals and the time spent for nutritional assessment [18].…”

Comparison of preoperative Nutritional Risk Index and Body Mass Index for predicting immediate postoperative outcomes following major gastrointestinal surgery: Cohort-study

“…Not only preoperative but also post-operative and post-discharge nutritional supplements and counseling were found to have an impact on the outcome following surgery [35]. New technologies like computer software and mobile apps have been implemented to diagnose and monitor malnutrition [36]. Similarly, the result of a multicenter randomized controlled phase IV trial for the preoperative use of novel immune-nutrition in liver resection for cancer is awaited [37].…”

A Dietary Assessment App for Hospitalized Patients at Nutritional Risk: Development and Evaluation of the MyFood App

“…In addition to validate the MyFood app with regard to the accuracy of dietary recording we also investigated the users’ experiences with the tool. A recent scoping review on the use of technology in identifying hospital malnutrition highlighted the importance of establishing usability rating to determine the app’s actual usefulness in practical settings [ 50 ].…”