Malnutrition in Hospitals

In hospitals worldwide, there is a public health issue of inadequate inpatient nutrition.

Physicians have known for more than a century that nutritional status of any patient has an influence on the course of disease. In 1872, Clouston recommended the use of intragastric feeding with milk, eggs, jelly, alcohol, and sugar for patients. Over the decades, health practitioners developed preparations with intravenous infusion of hydrolyzed casein, lipids, glucose, nitrogen, and crystalline amino acids [2].

In severe illness, there is a dramatic increase in the body’s metabolic demands. When critically ill patients become malnourished, there is predisposition for infection, inability to heal wounds, decubitus ulcers, falls, and other complications. They may suffer from immune system compromise, and those who require ventilator management may become dependent on the machine [2].

Inpatient Nutrition Screening

Upon arrival to a hospital for admission, nearly half of patients in the United States are already in a poor nutritional status. Moreover, of those who gain admission with satisfactory nutrition, a third may develop malnutrition within a few days [2]. This decline in their status is commonly the result of infectious disease and its effect on the human body’s metabolism [1].

Hospital accreditation guidelines in the United States require nutrition screening of all admissions within 24 hours and subsequent malnutrition risk assessments during the hospital stay [1]. The prevention and management of these issues necessitates an interdisciplinary approach with dieticians, nurses, pharmacists, and physicians [3].

Benefits of Nutrition Care

Efficient nutrition assessment and care reduce hospital length of stay, mortality rates, readmission occurrence, health care costs, and complications from the illness which brings the patient to the health care facility [1, 3].

It is also important to ensure that the patient continues to have an adequate status after discharge from the hospital. This entails discharge planning so food will be available and that special feeding techniques will continue without interruption.

Conclusion

Malnutrition in hospitalized patients is common today, and without adequate attention to the problem, a vicious cycle develops which interferes with the overall care of the patient.

References

Kirkland, L., Kashiwagi, D., Brantley, S. et al. (2012). Nutrition in the hospitalized patient. Journal of Hospital Medicine, 8, 52-58.
Seron-Arbeloa, C., Zamora-Elson, M., Labarta-Monzon, L. and Mallor-Bonet, T. (2013). Enteral nutrition in critical care. Journal of Clinical Medicine Research, 5, 1-11.
Tappenden, K., Quatrara, B., Parkhurst, M. et al. (2013). Critical role of nutrition in improving quality of care: an interdisciplinary call to action to address adult hospital malnutrition. Journal of Parenteral and Enteral Nutrition, 37, 482-497.
The photograph shows lower extremities of a patient with multiple vitamin deficiencies and skin changes as a result. Reprinted with permission from Centers for Disease Control.

Disclaimer

The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 01/04/2014, Michael_Koger

Thank you! Would you like to post a comment now?