Malnutrition in Hospitals a Worldwide Problem
Almost all of the patients over 70 residing in a Melbourne Australia teaching hospital were either malnourished or at risk of becoming malnourished a recent 2008 study showed. Malnutrition in hospitals is not a new entity. Looking at data from 1996, an article was published on the problem at hand in the United States where the study cited a prevalence of malnutrition to be 40-55% of the patients studied in the survey. Over 1,000 patients participated in this 1996 study in the U.S.
In the Melbourne study, 100 patients over the age of 70 were reviewed and 1/3 of them were found to be malnourished and 2/3 were found to be at risk for malnutrition.
The Melbourne study cited another example from 1974 entitled “The skeleton in the hospital closet” where nutritional inadequacies in New Zealand were brought to light. It seems that the problem of malnutrition in hospitals is worldwide and interventions need to be put in place to correct the problem at hand.
The Melbourne research states that health professionals focus on a patient’s presenting medical condition. Communication among allied health professionals is lacking and referrals to dietitians are infrequent.
In one case a cancer patient’s meals were taken away day after day untouched without a referral to a Dietitian. Dietitians have assessment screening forms in place to identify patients that are not eating, but rely on nursing to alert them as to the patients that are not consuming their food. Again, lack of communication and coordination between professionals was the culprit.
The researchers in Melbourne said only half of the patients experiencing a loss of appetite were detected by a health professional. They further stated that doctors and nurses tended to place more reliance on the patients being at a “healthy weight” than on recent involuntary weight loss, which with loss of appetite, is a better predictor of potential malnutrition.
The reasons for the high prevalence of malnutrition are multifaceted, such as a consequence of some diseases. Other reasons include lack of early recognition or the absence of access to appropriate medical nutrition therapy. Often medical nutrition therapy does not receive attention as a part of the medical care because it has been considered part of basic room and board costs. Lack of consistent reimbursement for nutrition assessment and therapies may also preclude identification and treatment of malnutrition and its early risk factor identification. Communication among health professionals is essential to good nutritional care for hospitalized patients to prevent malnutrition and its associated risk factors of increased morbidity and mortality.
Kathy Shattler received her Master of Science degree from Michigan State University in E. Lansing Michigan in Human Nutrition. Her twenty-two years of practice includes holding positions as a Lecturer, Chief Clinical Dietitian and Program Manager. Kathy is the Founder of Nutri-Care Consulting and is currently the Nutrition Director of www.CEU4U.COM, an online continuing education management company for Registered Dietitians and Dietetic Technicians.
