Malnutrition in Hospitalized Patients: Healthcare Elements

Summary

Malnutrition remains a cause for concern in the inpatient healthcare realm (Tappenden et al., 2013). According to the recent statistical data, in 2013, 1,950,000 cases of malnutrition among hospital patients were recorded in the United States (Weiss et al., 2013).

Research points to the fact that the patients receiving enteral or parenteral nutrition may suffer from malnutrition due to the following factors: “postsurgical nonabsorption, nutritional neglect, cachexia, protein-calorie malnutrition, weight loss or failure to thrive, and underweight” (Weiss et al., 2013). Therefore, malnutrition is typical of, although not restricted to, the environment of the ICU.

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The subject matter leads to dire outcomes on all levels including the cellular one unless managed properly. Without the required amount of nutrients, the patient’s immune system is affected significantly. Furthermore, muscle weakness is developed rapidly after a disruption in the microbiota in the patient’s gut (Bindels & Delzenne, 2013). Therefore, there is urgency in creating a program for problem management. When managing the problem, a healthcare professional (HP) must address the edema problem and provide supplementary feeding to the patient. Rehydration of the patient, as well as the monitoring of the possibility of heart failure, should also be listed among the key steps toward addressing the patient’s needs (Zhai, Dong, Bai, Wei, & Jia, 2017).

Healthcare Elements

Health Promotion

At present, there is a range of screening tools for preventing and detecting the issue of malnutrition at relatively early stages of its development. It is the sporadic use thereof that makes the process convoluted and ineffective (Becker et al., 2014). Therefore, it will be necessary to reconsider the current concept of health promotion by encouraging regular (at least weekly) use of such tools as Malnutrition Universal Screening Tool (MUST), the Mini Nutritional Assessment-Short Form (MNA-SF), and Bioelectrical Impedance Assessment (BIA). Despite the fact that MUST and BIA scored lower than MNA-SF in a recent study regarding their accuracy (MNA-SF showing higher incision rates), the combination of the three will help detect the problem at the earliest stages of its development and, thus, address it accordingly (Tappenden et al., 2013). Similarly, the GRAZ Malnutrition Test (GMT) should be viewed as an essential framework for detecting the threat of malnutrition and the development of the corresponding intervention strategies (Roller, Eglseer, Eisenberger, & Wirnsberger, 2016).

Health Protection

The measures for health protection, in their turn, will revolve primarily around increasing nurses’ competence levels and altering the current quality standards. The emphasis must be placed on patient-centered care. By stressing the necessity to engage in a multicultural dialogue with patients and identify the specific needs that are intrinsic to their background, nurses will be capable of isolating the factors that may contribute to the development of malnutrition and, thus, reduce their effect to a considerable extent (Porter, Haines, & Truby, 2017).

Furthermore, a set of clear and concise instructions and requirements must be provided to nurses so that they could act accordingly and address the incidences of malnutrition efficiently. For instance, rigid guidelines regarding nutritional screening at admission should be designed so that a careful assessment of the patient’s well-being could be conducted (Meehan et al., 2016).

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In addition, the nursing staff must receive extensive training so that they could use the appropriate strategies for meeting the patients’ nutritional needs. For instance, the staff must be aware of the techniques for carrying out patient surveys in the hospital setting. The adoption of the clinical leadership strategies will allow for multidisciplinary healthcare and, therefore, help improve the efficacy of the appropriate services delivery. Therefore, essential principles of leadership in the nursing setting must be taught to the staff members. Thus, malnutrition-related health promotion programs will have a tangible effect on the vulnerable population (Tappenden et al., 2013).

Moreover, supervision of the artificial nutrition process should take place in the hospital setting so that no misunderstandings regarding the feeding schedule or dosage could occur. As a result, all patients will be provided with the exact amount of food required to sustain their well-being (Geurden, Wouters, Franck, Weyler, & Ysebaert, 2013).

References

Becker, P., Carney, L. N., Corkins, M. R., Monczka, J., Smith, E., Smith, S. E., & Spear, B. E. (2014). Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: Indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition). Nutrition in Clinical Practice, 30(1), 147-161. Web.

Bindels, L. B., & Delzenne, N. M. (2013). Muscle wasting: The gut microbiota as a new therapeutic target? The International Journal of Biochemistry & Cell Biology, 45(10), 2186-2190. Web.

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Geurden, B., Wouters, C., Franck, E., Weyler, J., & Ysebaert, D. (2013). Does documentation in nursing records of nutritional screening on admission to hospital reflect the use of evidence-based practice guidelines for malnutrition? International Journal of Nursing Knowledge, 25(1), 43-48. Web.

Meehan, A., Loose, C., Jvawnna, B., Partridge, J., Nelson, J., & Goates, S. (2016). Health system quality improvement: Impact of prompt nutrition care on patient outcomes and health care costs. Journal of Nursing Care Quality, 31(3), 217-223. Web.

Porter, J., Haines, T. P., & Truby, H. (2017). The efficacy of protected mealtimes in hospitalized patients: a stepped wedge cluster randomised controlled trial. BMC Medicine, 15(25), 25-34. Web.

Roller, R. E., Eglseer, D., Eisenberger, A., & Wirnsberger, G. H. (2016). The Graz Malnutrition Screening (GMS): a new hospital screening tool for malnutrition. British Journal of Nutrition, 115(4), 650-657. Web.

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Tappenden, K. A., Quatrara, B., Parkhurst, M. L., Malone, A. M., Fanjiang, G., & Ziegler, T. R. (2013). Critical role of nutrition in improving quality of care: An interdisciplinary call to action to address adult hospital malnutrition. Journal of the Academy of Nutrition and Dietetics, 113(9), 1219-1237. Web.

Weiss, A., Fingar, K. R., Barrett, M. L., Elixhauser, A., Steiner, C. A., Guenter, P., & Brown, M. H. (2013). Characteristics of hospital stays involving malnutrition, 2013. Web.

Zhai, L., Dong, Y., Bai, Y., Wei, W., & Jia, L. (2017). Trends in obesity, overweight, and malnutrition among children and adolescents in Shenyang, China in 2010 and 2014: A multiple cross-sectional study. BMC Public Health, 17(1), 151-157. Web.

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