How well is your patient eating?
How often you ask this question could improve your hospital's readmission and length-of-stay rates, says Melissa Parkhurst, MD, FHM, medical director of hospital medicine and nutrition support at the University of Kansas Hospital in Kansas City.
A recent report from the Alliance to Advance Patient Nutrition [PDF]—a partnership of four organizations, including SHM, organized to improve nutrition screening and intervention among hospitalized patients—notes that about one in three patients admitted to a hospital meets the criteria for being malnourished. If left untreated, two-thirds of these patients will become more malnourished in the hospital.
"Often patients aren't eating because of testing or because their appetites are depressed because they're ill and not feeling well," says Dr. Parkhurst, an Alliance representative. "Sometimes their medications can alter their tastes, make them nauseated, or give them diarrhea."
Released last month, the findings are included in the partnership's first progress report. It describes the group's efforts in raising awareness about hospital nutrition, such as through info booths at medical meetings and via an online resource center on SHM's Center for Hospital Innovation & Improvement website.
Dr. Parkhurst points to studies that show inpatient malnutrition can lead to higher costs and more complications, as well as make patients more prone to surgical site infections, pressure ulcers, and falls.
"Malnourished patients are more apt to come back to the hospitals and to come in with complications," she says. "That is something we all should be concerned about as clinicians and at the hospital-administration level as well."
Here are Dr. Parkhurst's tips for improving nutrition among your patients:
- Ensure that every patient is getting a nutritional assessment upon admission and that staff is available to follow up with the results;
- Incorporate nutrition into the daily scope of patient care, for example, regularly ask staff whether your patients are eating or not;
- Include information about nutrition in the discharge plan and educate the patient’s family about nutritional interventions; and
- Work with hospital leadership to see how policies and procedures compare with the patient-care models put forth by the Alliance and note areas for improvement.