Multi-modal intervention improved oral intake in hospitalized patients. A one year follow-up study

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 34; no. 2; pp. 315 - 322
• Main Authors: Holst, M, Beermann, T, Mortensen, M.N, Skadhauge, L.B, Lindorff-Larsen, K, Rasmussen, H.H
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2015
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Dietary Proteins; Energy Intake; Female; Follow-Up Studies; Gastroenterology and Hepatology; Humans; Implementation; Inpatients; Intervention; Male; Malnutrition - diet therapy; Malnutrition - physiopathology; Malnutrition - prevention & control; Middle Aged; Multi professional; Nutrition recording; Nutrition teams; Nutritional Status; Nutritional Support - methods; Risk Factors; Sex Factors; Treatment Outcome; Undernutrition; Intervention; Nutrition recording; Nutrition teams; Multi professional; Undernutrition; Implementation
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2014.05.001

Summary Background Good nutritional practice (GNP) includes screening, nutrition plan and monitoring, and is mandatory for targeted treatment of malnourished patients in hospital. Aims To optimize energy- and protein-intake in patients at nutritional risk and to improve GNP in a hospital setting. Methods A 12-months observational multi-modal intervention study was done, using the top-down and bottom-up principle. All hospitalized patients (>3 days) were included. Setting : A university hospital with 758 beds and all specialities. Measurements : Record audit of GNP, energy- and protein-intake by 24-h recall, patient interviews and staff questionnaire before and after the intervention. Interventions : Based on pre-measurements, nutrition support teams in each department made targeted action plans, supervised by an expert team. Education, diagnose-specific nutrition plans, improved menus and eating environment, and awareness were initiated. Statistics : Mann–Whitney and Kruskal–Wallis test was used for ordinal data, and Pearson Chi square test for nominative data. Results Overall 545 patients participated (287 before/258 after) from 26/22 departments. There were no significant differences regarding sex, age, BMI or previous weight loss before and after the intervention. Result-indicators : Energy intake improved from 52% to 68% ( p  < 0.007), and protein intake from 33% to 52% ( p  < 0.001) (>75% of requirements). Intake of less than 50% of requirements decreased with 50%. Process-indicators : Screening improved from 56% to 77% ( p  < 0.001), nutrition plans from 21% to 56% ( p  < 0.0001), and monitoring food intake from 29% to 58% ( p  < 0.0001). Conclusions Intake of energy and protein as well as GNP improved using a multi-modal top-down and bottom-up approach.