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Implementation of nutritional guidelines in a university hospital monitored by repeated point prevalence surveys

BACKGROUND/OBJECTIVES: Malnutrition is present in 20–50% of hospitalized patients, and nutritional care is a challenge. The aim was to evaluate whether the implementation of a nutritional strategy would influence nutritional care performance in a university hospital. SUBJECTS/METHODS: This was a pro...

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Autores principales: Tangvik, R J, Guttormsen, A B, Tell, G S, Ranhoff, A H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303136/
https://www.ncbi.nlm.nih.gov/pubmed/21863042
http://dx.doi.org/10.1038/ejcn.2011.149
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author Tangvik, R J
Guttormsen, A B
Tell, G S
Ranhoff, A H
author_facet Tangvik, R J
Guttormsen, A B
Tell, G S
Ranhoff, A H
author_sort Tangvik, R J
collection PubMed
description BACKGROUND/OBJECTIVES: Malnutrition is present in 20–50% of hospitalized patients, and nutritional care is a challenge. The aim was to evaluate whether the implementation of a nutritional strategy would influence nutritional care performance in a university hospital. SUBJECTS/METHODS: This was a prospective quality improvement program implementing guidelines for nutritional care, with the aim of improving nutritional practice. The Nutrition Risk Screening (NRS) 2002 was used. Point prevalence surveys over 2 years to determine whether nutritional practice had improved. RESULTS: In total, 3604 (70%) of 5183 eligible patients were screened and 1230 (34%) were at nutritional risk. Only 53% of the at-risk patients got nutritional treatment and 5% were seen by a dietician. The proportion of patients screened increased from the first to the eighth point prevalence survey (P=0.012), but not the proportion of patients treated (P=0.66). The four initial screening questions in NRS 2002 identified 92% of the patients not at nutritional risk. CONCLUSIONS: Implementation of nutritional guidelines improved the screening performance, but did not increase the proportion of patients who received nutritional treatment. Point prevalence surveys were useful to evaluate nutritional practice in this university hospital. In order to improve practice, we suggest using only the four initial screening questions in NRS 2002 to identify patients not at risk, better education in nutritional care for physicians and nurses, and more dieticians employed. Audit of implementation of guidelines, performed by health authorities, and specific reimbursement for managing nutrition may also improve practice.
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spelling pubmed-33031362012-03-14 Implementation of nutritional guidelines in a university hospital monitored by repeated point prevalence surveys Tangvik, R J Guttormsen, A B Tell, G S Ranhoff, A H Eur J Clin Nutr Original Article BACKGROUND/OBJECTIVES: Malnutrition is present in 20–50% of hospitalized patients, and nutritional care is a challenge. The aim was to evaluate whether the implementation of a nutritional strategy would influence nutritional care performance in a university hospital. SUBJECTS/METHODS: This was a prospective quality improvement program implementing guidelines for nutritional care, with the aim of improving nutritional practice. The Nutrition Risk Screening (NRS) 2002 was used. Point prevalence surveys over 2 years to determine whether nutritional practice had improved. RESULTS: In total, 3604 (70%) of 5183 eligible patients were screened and 1230 (34%) were at nutritional risk. Only 53% of the at-risk patients got nutritional treatment and 5% were seen by a dietician. The proportion of patients screened increased from the first to the eighth point prevalence survey (P=0.012), but not the proportion of patients treated (P=0.66). The four initial screening questions in NRS 2002 identified 92% of the patients not at nutritional risk. CONCLUSIONS: Implementation of nutritional guidelines improved the screening performance, but did not increase the proportion of patients who received nutritional treatment. Point prevalence surveys were useful to evaluate nutritional practice in this university hospital. In order to improve practice, we suggest using only the four initial screening questions in NRS 2002 to identify patients not at risk, better education in nutritional care for physicians and nurses, and more dieticians employed. Audit of implementation of guidelines, performed by health authorities, and specific reimbursement for managing nutrition may also improve practice. Nature Publishing Group 2012-03 2011-08-24 /pmc/articles/PMC3303136/ /pubmed/21863042 http://dx.doi.org/10.1038/ejcn.2011.149 Text en Copyright © 2012 Macmillan Publishers Limited http://creativecommons.org/licenses/by-nc-nd/3.0/ This work is licensed under the Creative Commons Attribution-NonCommercial-No Derivative Works 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/
spellingShingle Original Article
Tangvik, R J
Guttormsen, A B
Tell, G S
Ranhoff, A H
Implementation of nutritional guidelines in a university hospital monitored by repeated point prevalence surveys
title Implementation of nutritional guidelines in a university hospital monitored by repeated point prevalence surveys
title_full Implementation of nutritional guidelines in a university hospital monitored by repeated point prevalence surveys
title_fullStr Implementation of nutritional guidelines in a university hospital monitored by repeated point prevalence surveys
title_full_unstemmed Implementation of nutritional guidelines in a university hospital monitored by repeated point prevalence surveys
title_short Implementation of nutritional guidelines in a university hospital monitored by repeated point prevalence surveys
title_sort implementation of nutritional guidelines in a university hospital monitored by repeated point prevalence surveys
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303136/
https://www.ncbi.nlm.nih.gov/pubmed/21863042
http://dx.doi.org/10.1038/ejcn.2011.149
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