KNOWLEDGE AND ATTITUDES OF NURSING STAFF TOWARDS MALNUTRITION CARE IN NURSING HOMES

Main Article Content

Maram Muneer Almutairi
Ebtisam Dowhis Alsahli
Moneera Abdullah Alkhaldi
Naifa manwer alanazi
Rehab Azo Alenzi
Hassna Mohammed Alanazi
Salma Dakhel Alanezi
Abdullah Ghithan alshamrani
Abdulaziz obaid mathker almotiri
Eid Shayem Alresheedi

Keywords

Hospital-Acquired Malnutrition, Nutritional Interventions, Clinical Trials, Enteral Nutrition.

Abstract

Introduction: Hospital-acquired malnutrition significantly impacts patient outcomes, healthcare costs, and morbidity and mortality rates. Despite its prevalence, it often remains underdiagnosed and undertreated in hospitalized patients. This systematic review aims to evaluate the effectiveness of nutritional interventions in preventing and treating hospital-acquired malnutrition among hospitalized adult patients, focusing on recent interventional studies and clinical trials to inform clinical practice and healthcare policy.


 


Methods: The review included interventional studies and clinical trials published in the last five years up to 2022, sourced from PubMed, Cochrane Library, CINAHL, and EMBASE. Inclusion criteria targeted studies evaluating nutritional interventions for adult hospitalized patients with hospital-acquired malnutrition, with outcomes such as nutritional status, length of hospital stay, readmission rates, and mortality. The study selection process involved screening, full-text review, and quality assessment using standardized tools, with data synthesis conducted qualitatively due to the expected heterogeneity .


 


Results: Six studies were included, with interventions ranging from oral nutritional supplements and individualized diet planning to enteral and parenteral nutrition. Key findings include a 20% to 50% greater likelihood of nutritional improvement or reduction in complications across the interventions. Notably, personalized nutritional support was associated with a risk ratio of 1.5 (95% CI: 1.2-1.9) for improved nutritional status, and oral nutritional supplements reduced complications with a risk ratio of 0.8 (95% CI: 0.65-0.98). Early initiation of enteral nutrition showed a 25% reduction in the risk of mortality with a risk ratio of 0.75 (95% CI: 0.59-0.95).


Conclusions: This review demonstrates the effectiveness of diverse nutritional interventions in mitigating the effects of hospital-acquired malnutrition. The findings support the integration of tailored nutritional strategies into patient care protocols to improve clinical outcomes in hospitalized patients. Implementing evidence-based nutritional interventions can significantly impact patient recovery, healthcare costs, and overall hospital efficiency.

Abstract 186 | PDF Downloads 76

References

1. Mezoff A, Gamm L, Konek S, Beal KG, Hitch D. Validation of a nutritional screen in children with respiratory syncytial virus admitted to an intensive care complex. Pediatrics. 1996;97(4):543-546.
2. Isabel M, Correia IT,Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr. 2003;22(3):235-239.
3. Edington J, Boorman J, Durrant ER, et al. Prevalence of malnutrition on admission to four hospitals in England. The Malnutrition Prevalence Group. Clin Nutr. 2000;19(3):191-195.
4. Lim SL, Ong KC, Chan YH, Loke WC, Ferguson M, Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr. 2012;31(3):345-350.
5. Schneider SM, Veyres P, Pivot X, et al. Malnutrition is an independent factor associated with nosocomial infections. Br J Nutr. 2004;92(1):105-111.
6. Mogensen K, Moromizato T, Rawn J, Christopher K. The association of malnutrition and mortality in critical illness (Abstr Suppl 1). Crit Care Med. 2012;40(12):S284.
7. Braunschweig C, Gomez S, Sheean PM. Impact of declines in nutritional status on outcomes in adult patients hospitalized for more than 7 days. J Am Diet Assoc. 2000;100(11):1316-1322.
8. Goiburu ME, Goiburu MM, Bianco H, et al. The impact of malnutrition on morbidity, mortality and length of hospital stay in trauma patients. Nutr Hosp. 2006;21(5):604-610.
9. Bell J, Bauer J, Capra S, Pulle CR. Barriers to nutritional intake in patients with acute hip fracture: time to treat malnutrition as a disease and food as a medicine? Can J Physiol Pharmacol. 2013;91(6):489-495.
10. Sullivan DH, Walls RC. Protein-energy undernutrition and the risk of mortality within six years of hospital discharge. J Am Coll Nutr. 1998;17(6):571-578.
11. Mowe M, Bohmer T. The prevalence of undiagnosed protein-calorie undernutrition in a population of hospitalized elderly patients. J Am Geriatr Soc. 1991;39(11):1089-1092.
12. Waitzberg DL, Caiaffa WT, Correia MI. Hospital malnutrition: the Brazilian national survey (IBRANUTRI): a study of 4000 patients. Nutrition. 2001;17(7–8):573-580.
13. Butterworth CE. The skeleton in the hospital closet. Nutr Today. 1974;9(2):4-8.
14. Robinson MK, Mogensen KM, Casey JD, et al. The relationship among obesity, nutritional status, and mortality in the critically ill. Crit Care Med. 2015;43(1):87-100.
15. White JV, Guenter P, Jensen G, et al. Characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). JPEN J Parenter Enteral Nutr. 2012;36:275-283.
16. Anthony PS. Nutrition screening tools for hospitalized patients. Nutr Clin Pract. 2008;23(4):373-382.
17. van Bokhorst-de van der Schueren MA, Guaitoli PR, Jansma EP, de Vet HC. Nutrition screening tools: does one size fit all? A systematic review of screening tools for the hospital setting. Clin Nutr. 2014;33(1):39.
18. Evans WJ. Skeletal muscle loss: cachexia, sarcopenia, and inactivity. Am J Clin Nutr. 2010;91(4):1123S-1127S.
19. Späte U, Schulze PC. Proinflammatory cytokines and skeletal muscle. Curr Opin Clin Nutr Metab Care. 2004;7(3):265- 269.
20. Dupertuis YM, Kossovsky MP, Kyle UG, Raguso CA, Genton L, Pichard C. Food intake in 1707 hospitalised patients: a prospective comprehensive hospital survey. Clin Nutr. 2003;22(2):115-123.
21. Agarwal E, Ferguson M, Banks M, Bauer J, Capra S, Isenring E. Nutritional status and dietary intake of acute care patients: results from the Nutrition Care Day Survey 2010. Clin Nutr. 2012;31(1):41-47.
22. Peterson SJ, Tsai AA, Scala CM, Sowa DC, Sheean PM, Braunschweig CL. Adequacy of oral intake in critically ill patients 1 week after extubation. J Am Diet Assoc. 2010;110(3):427-433.
23. Lazarus C, Hamlyn J. Prevalence and documentation of malnutrition in hospitals: a case study in a large private hospital setting. Nutr Diet. 2005;62(1):41-47.