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General and Risk Management, Patient Safety (including: medication errors, quality control)
Optimisation of available resources in the implementation of a nutritional screening method
  1. G.I. Ballesteros Cabañas,
  2. N. Roca Rossellini,
  3. M. Pons Busom,
  4. I. Javier Castro,
  5. E. Ramió Montero,
  6. N. El Hilari Masó,
  7. N. Pi Sala,
  8. B. Eguileor Partearroyo
  1. 1Capio Hospital Universitari Sagrat Cor, Pharmacy, Barcelona, Spain
  2. 2Capio Hospital Universitari Sagrat Cor, Surgery-Nutrition Unit, Barcelona, Spain

Abstract

Background The prevalence of hospital malnutrition ranges between 30 and 55%. As malnutrition increases with hospital stay duration, consequences are both clinical and economic, resulting in increased morbidity and mortality.

Purpose To analyse if the current resources allow us to implement a nutritional screening system NRS-2002 (Nutritional Risk Screening-2002) or the authors should adapt this method to our centre.

Materials and methods Study carried out in a 300-bed hospital. The authors included all patients>18 years and with expected stay>1 day. The authors calculated the time spent in each interview, how many patients may require nutritional assessment and whether it would be possible to perform screening of all income. Finally, The authors evaluated how to implement the NRS-2002 to detect the maximum number of patients at risk of malnutrition.

Results During the study period 505 patients were admitted in our hospital, 45% were excluded (stay≤1 day). Of the 277 included, 20% did not know or could not answer to the nutritional survey (NK/NA). The average age of the NK/NA group was higher than the rest: 84.3 (SD11.4) versus 71.5 (SD15.6) years (F=8.8 p<0.003). The average time spent doing the interview was 10.8 (SD3.3) min. The average hospitalisation stay was 7.5 (SD6.6) days with significant differences (F=7.2 p=0.008) by services: medical (MS) 8.7(SD7.1) and surgical (SS) 6.1 (SD 5.5). 57.9% of patients of MS had nutritional risk compared to 37.3% of patients of SS (χ2=9.4 p=0.002). 92.5% of the patients needed the ‘final-test’; wherein>50% required nutritional assessment. Admissions average by day in our hospital is 38 patients. According to the results of this study, screening should be performed in 17 patients, and eight may require nutritional assessment.

Conclusions The authors can not implement this screening method for all admitted patients using the available resources. In order to optimise resources and to detect a largest number of nutritional risk patients, The authors decide to perform the NRS-2002 at 5th day of stay. For those patients that can not answer the NRS-2002, the authors decide to implement the short MNA-2009 (Mini Nutritional Assessment-2009).

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