Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

An interdisciplinary approach to hospital malnutrition

Kelly A. Tappenden, PhD, RD
Conditions
October 25, 2014
Share
Tweet
Share

Hendersonville, North Carolina may not have a Mayo Clinic that is known for medical innovation, but it is making waves in solving a stubborn problem in health care: malnutrition.

Pardee UNC Health Care is implementing a new nursing protocol that puts nutrition at the center of the care team and the locus for reducing readmissions, pressure ulcers and lengths of stay.

Pardee’s efforts come as more and more studies document the seriousness of the malnutrition problem: One in three Americans is malnourished upon admission to the hospital. And that may be an underestimate. A new study in the Annals of Emergency Medicine finds that nearly two-thirds of patients over 65 admitted to the emergency department at UNC Health Care are either malnourished or at risk for malnutrition.

What’s particularly insidious is that those most affected are our parents and grandparents as malnutrition most often afflicts older adults with cancer and debilitating chronic diseases. As a result, malnutrition delays recovery and is associated with a range of adverse outcomes, including surgical site infections, pressure ulcers and falls. The end result is more time in the hospital per patient, more patients who have to be readmitted after discharge and an almost three-fold increase in hospital costs.

Despite these consequences, malnutrition remains largely untreated in U.S. hospitals, which is why the Academy of Medical-Surgical Nurses, the Academy of Nutrition and Dietetics, the Society of Hospital Medicine and Abbott Nutrition came together to form an unprecedented consortium — the Alliance to Advance Patient Nutrition — to address the under-recognized and under-treated issue of malnutrition in hospitalized patients.

Mounting evidence finds that good hospital nutrition results in a 25 percent reduction in the incidence of pressure ulcers, 14 percent fewer overall complications, two fewer days in the hospital, and a 28 percent drop in avoidable hospital readmissions.

The Alliance recently issued its one year anniversary report — Alleviating Hospital-Based Malnutrition: A Baseline Progress Report— which documents a growing recognition of this pervasive public health problem and a greater focus on instituting effective nutrition practices in hospitals.

As untreated malnutrition can delay recovery and increase medical complications, the Alliance to Advance Patient Nutrition was formed in May 2013 to drive awareness and systemic change at the nation’s hospitals. The Alliance issued a consensus paper and published specific recommendations for hospital administrators and clinicians to institute effective nutrition practices along with the resources and tools to put these recommendations into practice.

A year later, qualitative results indicate that multidisciplinary care teams are implementing the Alliance’s recommendations across the country. In addition to Pardee, a number of hospitals are working to incorporate Alliance recommendations into their processes.

For instance, Mercy Health, a large system of 21 hospitals based in Cincinnati, Ohio, implemented a multidisciplinary approach to identify and treat malnourished patients. Mercy teams also provide standardized written instructions for nutrition care at discharge with the goal of reducing readmission risk.

In the Detroit area, TouchPoint Support Services at St. John Providence Health System is now screening 100 percent of its patients upon admission and providing ongoing assessment for every patient diagnosed as malnourished.

One Pardee nurse expressed astonishment that it has taken hospitals so long to address such a seemingly simple problem, but now teams provide medical nutrition therapy to those who are malnourished at the outset of their stays and include any necessary instructions for oral nutrition supplementation in the patient’s discharge orders.

There is a growing body of evidence supporting the positive impact nutrition has on improving patient outcomes. We are seeing that early intervention can make a significant difference. It is necessary to work with the entire team to ensure that nutrition is an integral part of our patients’ treatment plans.

ADVERTISEMENT

Kelly A. Tappenden is a professor of nutrition and gastrointestinal physiology, University of Illinois, Urbana-Champaign and a clinical representative in the Alliance to Advance Patient Nutrition. 

Prev

5 reasons why physician champions are needed

October 25, 2014 Kevin 11
…
Next

Ebola: Local hospitals cannot be prepared

October 25, 2014 Kevin 18
…

Tagged as: Hospital-Based Medicine

Post navigation

< Previous Post
5 reasons why physician champions are needed
Next Post >
Ebola: Local hospitals cannot be prepared

ADVERTISEMENT

More in Conditions

  • How President Biden’s cognitive health shapes political and legal trust

    Muhamad Aly Rifai, MD
  • The emotional first responders of aesthetic medicine

    Sarah White, APRN
  • Why testosterone matters more than you think in women’s health

    Andrea Caamano, MD
  • How veteran health care is being transformed by tech and teamwork

    Deborah Lafer Scher
  • What Elon Musk and Diddy reveal about the price of power

    Osmund Agbo, MD
  • Understanding depression beyond biology: the power of therapy and meaning

    Maire Daugharty, MD
  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

An interdisciplinary approach to hospital malnutrition
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...