Estimated inpatient malnutrition prevalence, screening tool utilization, and dietitian referral rates across hospitals during extension of phase 2 of More-2-Eat
Summary: Background & Aims: Malnutrition is associated with increased hospital length of stay, disease burden, and healthcare costs. The Integrated Nutrition Pathway for Acute Care (INPAC) is a validated multi-step algorithm that includes screening using the Canadian Nutrition Screening Too...
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Elsevier
2025-04-01
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| Series: | Clinical Nutrition Open Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667268525000075 |
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| author | Yingying Xu Rachel A. Warren Shirley M. Peters Sonya Boudreau Tina N. Strickland Mari Somerville Brenda L. MacDonald Heather Keller Leah E. Cahill |
| author_facet | Yingying Xu Rachel A. Warren Shirley M. Peters Sonya Boudreau Tina N. Strickland Mari Somerville Brenda L. MacDonald Heather Keller Leah E. Cahill |
| author_sort | Yingying Xu |
| collection | DOAJ |
| description | Summary: Background & Aims: Malnutrition is associated with increased hospital length of stay, disease burden, and healthcare costs. The Integrated Nutrition Pathway for Acute Care (INPAC) is a validated multi-step algorithm that includes screening using the Canadian Nutrition Screening Tool (CNST) and diagnosis using Subjective Global Assessment (SGA). This study aims to understand (1) the prevalence of inpatient nutrition screening completion, (2) the proportion of at-risk inpatients referred to dietitians, and (3) the malnutrition prevalence among a sample of hospital inpatients. Methods: In 2021, INPAC was implemented in five hospital wards across Nova Scotia (NS) as an extension of More-2-Eat NS Study. As part of the implementation, hospital chart audits (n=672) were completed from 2021-2022 to gather data on malnutrition screening, dietitian referral, and nutrition assessment. Statistical analysis involved chi-square, Kruskal Wallis, and t-tests. Results: Nutrition screening at admission occurred for 54.9% of audited patients, with variation among sites (p<0.001). 34.5% of these screened patients were at nutritional risk, of whom 79.8% were referred to a dietitian. 14.4% of all charts audited had a malnutrition diagnosis as per SGA, as did 28.5% of patients screened by the CNST. 94.2% of patients who underwent SGA were diagnosed with malnutrition. Conclusion: Inpatient malnutrition is prevalent in NS hospitals but under-diagnosed due to gaps in screening. INPAC implementation increased dietitian referrals, SGA, and malnutrition diagnosis. Investigation is needed to assess and overcome barriers to screening, consequences to clinician workload, and the burden of malnutrition on prognosis and hospital stay. |
| format | Article |
| id | doaj-art-42d29e2e79ee411b9187c049844434be |
| institution | Kabale University |
| issn | 2667-2685 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Nutrition Open Science |
| spelling | doaj-art-42d29e2e79ee411b9187c049844434be2025-02-07T04:48:30ZengElsevierClinical Nutrition Open Science2667-26852025-04-01603849Estimated inpatient malnutrition prevalence, screening tool utilization, and dietitian referral rates across hospitals during extension of phase 2 of More-2-EatYingying Xu0Rachel A. Warren1Shirley M. Peters2Sonya Boudreau3Tina N. Strickland4Mari Somerville5Brenda L. MacDonald6Heather Keller7Leah E. Cahill8Department of Medicine, Dalhousie University, 5790 University Ave, Halifax, NS, CanadaDepartment of Medicine, Dalhousie University, 5790 University Ave, Halifax, NS, Canada; Nova Scotia Health, 5909 Veterans Memorial Ln, Halifax, NS, CanadaNova Scotia Health, 5909 Veterans Memorial Ln, Halifax, NS, CanadaNova Scotia Health, 5909 Veterans Memorial Ln, Halifax, NS, CanadaNova Scotia Health, 5909 Veterans Memorial Ln, Halifax, NS, CanadaNova Scotia Health, 5909 Veterans Memorial Ln, Halifax, NS, Canada; IWK Health, 5980 University Ave, Halifax, NS, CanadaNova Scotia Health, 5909 Veterans Memorial Ln, Halifax, NS, CanadaDepartment of Kinesiology & Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada; Schlegel-UW Research Institute for Aging, 250 Laurelwood Dr, Waterloo, ON, CanadaDepartment of Medicine, Dalhousie University, 5790 University Ave, Halifax, NS, Canada; Nova Scotia Health, 5909 Veterans Memorial Ln, Halifax, NS, Canada; Corresponding author. Department of Medicine, Dalhousie University, 5790 University Ave, Halifax NS, B3H 1V7, Canada.Summary: Background & Aims: Malnutrition is associated with increased hospital length of stay, disease burden, and healthcare costs. The Integrated Nutrition Pathway for Acute Care (INPAC) is a validated multi-step algorithm that includes screening using the Canadian Nutrition Screening Tool (CNST) and diagnosis using Subjective Global Assessment (SGA). This study aims to understand (1) the prevalence of inpatient nutrition screening completion, (2) the proportion of at-risk inpatients referred to dietitians, and (3) the malnutrition prevalence among a sample of hospital inpatients. Methods: In 2021, INPAC was implemented in five hospital wards across Nova Scotia (NS) as an extension of More-2-Eat NS Study. As part of the implementation, hospital chart audits (n=672) were completed from 2021-2022 to gather data on malnutrition screening, dietitian referral, and nutrition assessment. Statistical analysis involved chi-square, Kruskal Wallis, and t-tests. Results: Nutrition screening at admission occurred for 54.9% of audited patients, with variation among sites (p<0.001). 34.5% of these screened patients were at nutritional risk, of whom 79.8% were referred to a dietitian. 14.4% of all charts audited had a malnutrition diagnosis as per SGA, as did 28.5% of patients screened by the CNST. 94.2% of patients who underwent SGA were diagnosed with malnutrition. Conclusion: Inpatient malnutrition is prevalent in NS hospitals but under-diagnosed due to gaps in screening. INPAC implementation increased dietitian referrals, SGA, and malnutrition diagnosis. Investigation is needed to assess and overcome barriers to screening, consequences to clinician workload, and the burden of malnutrition on prognosis and hospital stay.http://www.sciencedirect.com/science/article/pii/S2667268525000075MalnutritionClinical nutritionNutrition screeningNutrition assessment |
| spellingShingle | Yingying Xu Rachel A. Warren Shirley M. Peters Sonya Boudreau Tina N. Strickland Mari Somerville Brenda L. MacDonald Heather Keller Leah E. Cahill Estimated inpatient malnutrition prevalence, screening tool utilization, and dietitian referral rates across hospitals during extension of phase 2 of More-2-Eat Clinical Nutrition Open Science Malnutrition Clinical nutrition Nutrition screening Nutrition assessment |
| title | Estimated inpatient malnutrition prevalence, screening tool utilization, and dietitian referral rates across hospitals during extension of phase 2 of More-2-Eat |
| title_full | Estimated inpatient malnutrition prevalence, screening tool utilization, and dietitian referral rates across hospitals during extension of phase 2 of More-2-Eat |
| title_fullStr | Estimated inpatient malnutrition prevalence, screening tool utilization, and dietitian referral rates across hospitals during extension of phase 2 of More-2-Eat |
| title_full_unstemmed | Estimated inpatient malnutrition prevalence, screening tool utilization, and dietitian referral rates across hospitals during extension of phase 2 of More-2-Eat |
| title_short | Estimated inpatient malnutrition prevalence, screening tool utilization, and dietitian referral rates across hospitals during extension of phase 2 of More-2-Eat |
| title_sort | estimated inpatient malnutrition prevalence screening tool utilization and dietitian referral rates across hospitals during extension of phase 2 of more 2 eat |
| topic | Malnutrition Clinical nutrition Nutrition screening Nutrition assessment |
| url | http://www.sciencedirect.com/science/article/pii/S2667268525000075 |
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