Malnutrition in an acute regional hospital setting: Implications for practice based on hospital screening, prevalence and identification.

(1)

Malnutrition in an Acute Regional Hospital Setting: Implications for practice based on hospital screening, prevalence and

identification

November 2022 Victoria Williams, Kerri Gordon, Alesha Sayner, Nicole O’Loughlin,

Sarah Ryan, Fiona McLean, Larissa Telfer, Andrea Pinch

(2)

Background:

• 40% acute hospital malnutrition

¹

⚬ Sarcopenia

⚬ Impaired wound healing

⚬ Increased length of admission

• Validated screening & assessment tools

⚬ Malnutrition Screening Tool (MST)

⚬ Subjective Global Assessment

(SGA)

(3)

Background:

d

(4)

Aims:

1

Determine the

prevalence of malnutrition

in acute

hospitalised patients

2

To measure the

prevalence of hospital vs.

community- acquired malnutrition

3

Assess

completion of weight

documentatio

n and MSTs

(5)

Methods

Point of

Prevalence Review

Prospective audit

Review of medical Histories

Patient outcomes

Analysis of data

Descriptive Statistics

Future direction

Liaising with key stakeholders

(6)

Results: • Completion on admission

⚬ 58% weights

⚬ 55% MST

• 83 Patients

• 44.5% scored MST ≥2

• SGA: 38% Malnutrition

⚬ B = 76%

mild/moderate

⚬ C = 24% severe

SGA not indicated

49.3% SGA B

29.3%

SGA A 12%

SGA C

9.3%

(7)

Results:

29 Patients with malnutrition:

Comm. acquired:

65.5%

Hosp. acquired: 24.2%

Undefined: 10.3%

0 25 50 75

CAM

HAM

Undefined

(8)

Discussion:

• Admission goal: 100% of patients screened

• Accuracy of MST completion

²

2014 2018 2022

MST Completion

68% 50% 55%

SGA B 74% - 76%

SGA C 26% - 24%

Weight documented

on Admission - 63% 58%

• Referral completion

³

• Penalties of HAM

⁴

(9)

Clinical Implications:

• Dietitians role in ID and addressing barriers

• Providing education

• Policy and procedures

• Clear clinical pathways

• Ongoing research

(10)

Conclusions:

Nutrition and hydration risk

screening upon patient

admission

1

SGA's on all 'at risk' patients

with

documentation of Hospital vs.

Community

2

Regular auditing to monitor outcomes

following intervention implementation

3

(11)

1. Agarwal E, Ferguson M, Banks M, Batterham M, Bauer J, Capra S, Isenring E. (2013) Malnutrition and poor food

intake are associated with prolonged hospital stay, frequent readmissions, and great in-hospital mortality: Results from the Nutrition Day Survey 2010. Clinical Nutrition: 32: 737- 745

2. White J, Guenter P, Jensen GJJOP, NUTRITION E.

Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition:

characteristics recommended for the identification and

documentation of adult malnutrition (undernutrition)(vol 36, pg 275, 2012). 2017;41(3):520.

3. Gout, B.S, Barker, L.A, Crowe, T.C (2009). Malnutrition identification, diagnosis and dietetic referrals: Are we doing a good enough job?. Nutrition & Dietetics: 66: 206-211

4. Makhija S, Baker J. The Subjective Global Assessment:

a review of its use in clinical practice. Nutr Clin Pract 2008;

23: 405–9

Reference

s:

(12)

Thank you

Victoria Williams

E: [email protected]