Sherry CL, Sauer AC, Thrush KE, et al.
Current developments in nutrition. Date of publication 2017 Oct 16;volume 1(11):e001297.
1. Curr Dev Nutr. 2017 Oct 16;1(11):e001297. doi: 10.3945/cdn.117.001297.
eCollection 2017 Nov.
Assessment of the Nutrition Care Process in US Hospitals Using a Web-Based Tool
Demonstrates the Need for Quality Improvement in Malnutrition Diagnosis and
Discharge Care.
Sherry CL(1), Sauer AC(1), Thrush KE(1).
Author information:
(1)Scientific and Medical Affairs, Abbott Nutrition, Columbus, OH.
Background: Malnutrition in hospitalized patients is a pervasive problem in the
United States. To our knowledge, although malnutrition has been acknowledged as a
concern for >40 y, it has not yet been well addressed with a systematic, process
improvement approach. Objectives: We aimed to characterize the current nutrition
care process in US hospitals to establish a baseline for improvements. We also
aimed to demonstrate the application of a web-based quality improvement tool as a
simple approach to address malnutrition in hospitalized patients. Methods: We
established a web-based tool to measure and assess nutrition care practices from
hospital electronic medical records. Individual institutions self-selected to
participate and were assigned a unique identifier to input data. Aggregated
patient data from registered institutions were assessed. Data from all
institutions were combined and are presented as the totals for each variable.
Results: Of 243 registered users, 97 provided data and 150 reports were included
in the analysis, resulting in a total of 107,106 patients. Almost all patients
(89.98%) were screened for malnutrition risk within 24 h of admission, and ∼30%
were at risk for malnutrition. Of those at risk, ∼65% received a registered
dietitian nutritionist consultation or an order for an oral nutrition supplement.
The rate of malnutrition diagnosis for those at risk was ∼14%, and <10% of
patients received a recommendation or prescription for an oral nutrition
supplement at discharge. Conclusions: Malnutrition remains an issue for
hospitalized patients, particularly the gap between those screened as at risk and
those diagnosed with malnutrition. Moreover, discharge recommendations for
patients who are screened as at risk for malnutrition are also lacking. These
data demonstrate that a web-based quality improvement tool could be used to
capture the nutrition care practice at an institution level to provide directed
approaches for addressing hospital malnutrition and improving care of patients at
risk for malnutrition.
DOI: 10.3945/cdn.117.001297
PMCID: PMC5998791
PMID: 29955685
