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Identification of nutritional risk in the acute care setting: progress towards a practice and evidence informed systems level approach

BACKGROUND: To improve nutritional assessment and care pathways in the acute care setting, it is important to understand the indicators that may predict nutritional risk. Informed by a review of systematic reviews, this project engaged stakeholders to prioritise and reach consensus on a list of evid...

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Autores principales: Diane, Chamberlain, Sebastian, Doeltgen, Reegan, Knowles, Alison, Yaxley, Michelle, Miller
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8638168/
https://www.ncbi.nlm.nih.gov/pubmed/34847947
http://dx.doi.org/10.1186/s12913-021-07299-y
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author Diane, Chamberlain
Sebastian, Doeltgen
Reegan, Knowles
Alison, Yaxley
Michelle, Miller
author_facet Diane, Chamberlain
Sebastian, Doeltgen
Reegan, Knowles
Alison, Yaxley
Michelle, Miller
author_sort Diane, Chamberlain
collection PubMed
description BACKGROUND: To improve nutritional assessment and care pathways in the acute care setting, it is important to understand the indicators that may predict nutritional risk. Informed by a review of systematic reviews, this project engaged stakeholders to prioritise and reach consensus on a list of evidence based and clinically contextualised indicators for identifying malnutrition risk in the acute care setting. METHODS: A modified Delphi approach was employed which consisted of four rounds of consultation with 54 stakeholders and 10 experts to reach consensus and refine a list of 57 risk indicators identified from a review of systematic reviews. Weighted mean and variance scores for each indicator were evaluated. Consistency was tested with intra class correlation coefficient. Cronbach's alpha was used to determine the reliability of the indicators. The final list of indicators was subject to Cronbach’s alpha and exploratory principal component analysis. RESULTS: Fifteen indicators were considered to be the most important in identifying nutritional risk. These included difficulty self-feeding, polypharmacy, surgery and impaired gastro-intestinal function. There was 82% agreement for the final 15 indicators that they collectively would predict malnutrition risk in hospital inpatients. CONCLUSION: The 15 indicators identified are supported by evidence and are clinically informed. This represents an opportunity for translation into a novel and automated systems level approach for identifying malnutrition risk in the acute care setting. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-07299-y.
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spelling pubmed-86381682021-12-02 Identification of nutritional risk in the acute care setting: progress towards a practice and evidence informed systems level approach Diane, Chamberlain Sebastian, Doeltgen Reegan, Knowles Alison, Yaxley Michelle, Miller BMC Health Serv Res Research BACKGROUND: To improve nutritional assessment and care pathways in the acute care setting, it is important to understand the indicators that may predict nutritional risk. Informed by a review of systematic reviews, this project engaged stakeholders to prioritise and reach consensus on a list of evidence based and clinically contextualised indicators for identifying malnutrition risk in the acute care setting. METHODS: A modified Delphi approach was employed which consisted of four rounds of consultation with 54 stakeholders and 10 experts to reach consensus and refine a list of 57 risk indicators identified from a review of systematic reviews. Weighted mean and variance scores for each indicator were evaluated. Consistency was tested with intra class correlation coefficient. Cronbach's alpha was used to determine the reliability of the indicators. The final list of indicators was subject to Cronbach’s alpha and exploratory principal component analysis. RESULTS: Fifteen indicators were considered to be the most important in identifying nutritional risk. These included difficulty self-feeding, polypharmacy, surgery and impaired gastro-intestinal function. There was 82% agreement for the final 15 indicators that they collectively would predict malnutrition risk in hospital inpatients. CONCLUSION: The 15 indicators identified are supported by evidence and are clinically informed. This represents an opportunity for translation into a novel and automated systems level approach for identifying malnutrition risk in the acute care setting. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-07299-y. BioMed Central 2021-11-30 /pmc/articles/PMC8638168/ /pubmed/34847947 http://dx.doi.org/10.1186/s12913-021-07299-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Diane, Chamberlain
Sebastian, Doeltgen
Reegan, Knowles
Alison, Yaxley
Michelle, Miller
Identification of nutritional risk in the acute care setting: progress towards a practice and evidence informed systems level approach
title Identification of nutritional risk in the acute care setting: progress towards a practice and evidence informed systems level approach
title_full Identification of nutritional risk in the acute care setting: progress towards a practice and evidence informed systems level approach
title_fullStr Identification of nutritional risk in the acute care setting: progress towards a practice and evidence informed systems level approach
title_full_unstemmed Identification of nutritional risk in the acute care setting: progress towards a practice and evidence informed systems level approach
title_short Identification of nutritional risk in the acute care setting: progress towards a practice and evidence informed systems level approach
title_sort identification of nutritional risk in the acute care setting: progress towards a practice and evidence informed systems level approach
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8638168/
https://www.ncbi.nlm.nih.gov/pubmed/34847947
http://dx.doi.org/10.1186/s12913-021-07299-y
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