Trends and Novel Research in Hospital Nutrition Care: A Narrative Review of Leading Clinical Nutrition Journals

Abstract

Hospital malnutrition is a longstanding problem that continues to be underrecognized and undertreated. The aim of this narrative review is to summarize novel, solution-focused, recent research or commentary to update providers on the prevention of iatrogenic malnutrition as well as the detection and treatment of hospital malnutrition. A narrative review was completed using the top 11 clinically relevant nutrition journals. Of the 13,850 articles and editorials published in these journals between 2013 and 2019, 511 were related to hospital malnutrition. A duplicate review was used to select (n = 108) and extract key findings from articles and editorials. Key criteria for selection were population of interest (adult hospital patients, no specific diagnostic group), solutionfocused, and novel perspectives. Articles were categorized (6 classified in >1 category) as Screening and Assessment (n = 17), Standard (n = 25), Advanced (n = 12) and Specialized Nutrition Care (n = 8), Transitions (n = 15), Multicomponent (n = 21), Education and Empowerment (n = 9), Economic Impact (n = 3), and Guidelines (n = 4) for summarizing. Research advances in screening implementation, standard nutrition care, transitions, and multicomponent interventions provide new strategies to consider for malnutrition prevention (iatrogenic), detection, and care. However, several areas requiring further research were identified. Specifically, larger and more rigorous studies that examine health outcomes and economic analyses are urgently needed.

Prevalence of current nutrition care practices for disease-related malnutrition in Canadian hospitals

“…It is well-recognized that disease-related malnutrition is common in hospital patients and timely and appropriate interventions are needed to promote patient recovery, decrease length of stay, and support a successful transition to the community (Allard et al 2016;Gomez et al 2022). Screening and assessment are key steps to identifying and treating malnutrition and more research on implementation has occurred over the past decade (Keller et al 2021a). In 2015, the Integrated Nutrition Pathway for Acute Care, a consensus and evidencebased care process designed for the Canadian hospital context was developed to establish best practices for identifying and treating malnutrition in hospital patients (Keller et al 2015).…”

The role of trained champions in sustaining and spreading nutrition care improvements in hospital: qualitative interviews following an implementation study

“…4 5 Multicomponent interventions have demonstrated improved nutrition care practices and outcomes, and there is increasing understanding of how to implement these interventions. [6][7][8][9][10][11][12][13] However, little is known about how What this paper adds ► This study explores how trained local champions supported the sustainability and spread of nutrition care improvements in multiple hospital units across Canada. ► Having trained champions who demonstrate continual and evolving understanding of key concepts for implementation was necessary.…”