critical role of nutrition in improving quality of care rural health conference/presentations...
TRANSCRIPT
CRITICAL ROLE OF NUTRITION
IN IMPROVING QUALITY OF CARE Koree Muska, RDN, Clinical Nutrition Manager
Hills & Dales Hospital
WHAT IS MALNUTRITION
mal·nu·tri·tion
ˌmaln(y)o͞oˈtriSH(ə)n/
noun
noun: malnutrition
lack of proper nutrition, caused by not
having enough to eat, not eating
enough of the right things, or being
unable to use the food that one does
eat.
synonyms:undernourishment,
malnourishment, poor diet,
inadequate diet, unhealthy diet,
lack of food; Morehunger,
starvation
"the malnutrition of millions around
the world is shameful"
• Not having enough to eat
• Not eating enough of the right things/ eating too much of the wrong things
• Not being able to use the food that one does eat
WHAT IS MALNUTRITION
Not eating enough Not eating enough of the right things/eating too much of the wrong things
WHY WE CARE/ THE BURDEN
Patients who become malnourished are at
increased risk of 1,2
Hospital admission/readmission
Longer length of hospital stays
Increased risk pressure ulcers
Impaired wound healing
Immune suppression
Increased rate of infection
Muscle wasting and functional loss increasing the
risk of falls
Higher treatment costs
Increased mortality
THE IMPACT OF EARLY INTERVENTIONS ON
KEY OUTCOMES FOR OUR PATIENTS
Nutrition interventions can: Reduce complication rates
Reduce length of hospital stay
Reduce reemissions
Reduce cost of care to the patient
Reduce mortality
Examples of nutrition interventions Food and nutrient delivery
Meals on wheels, oral nutritional supplements, adaptive equipment, Food drug interactions
Nutrition education DSMT programs, MSU extensions Cooking Matters Programs, In
Clinic education by utilizing your hospitals Nutrition Care Manual
Nutrition counseling Medical Nutrition Therapy, Intensive behavioral therapy for Obesity,
Coordination of nutrition care
MALNUTRITION IDENTIFICATION, NUTRITION
INTERVENTIONS, AND CONTINUED MONITORING
(FROM HOSPITAL DISCHARGE TO PRIMARY CARE)
In order to be successful
Nutrition must be a component of all clinicians
Developing , clear standardized written instruction
for nutrition care to follow at home
Detailed diet instruction (use your nutrition care manual,
you have one it’s a CMS requirement)
Recommendations for ONS, vitamin and or mineral
supplements and rationale
Read the nutrition care plan, and nutrition note if the
patient was dx of malnourished
REFERENCES
1)Tappenden.KA, Quatrara B. The Critical role of
Nutrition in Imroving Quality of Care:An
Interdisciplinary Call to Action to Address Adult
Hospital Malnutrition,Journal of the Academy of
Nutrition and Dietetics 2013;113(9):1219-1237
2)McCauly S, Malnutrition Care: Preparing for
the next Level of Quality, Journal of the
Academy of Nutrition and Dietetics
2016;116(5):852-855
FOR FURTHER INFORMATION ON
INFLAMMATORY BOWEL DISEASE
Colombel. JF, Watson A, Newrath MF. The 10 remaining mysteries of Inflammatory Bowel diseas, GUT 2008;57:429-433
Toreson R, Cull JJ. Pathophysiology of Inflammatory Bowel Disease and Overview. Surg.Clin. North AM 2007 June’87(3);575-585
Lawrance IC, Murray K, Batman B. Crohn’s Disease and Smoking is it ever too late to quit?. JCC Dec, 2013;7 (12):e665-e671
Carbonnell F, Jantchou P, Monnet E. Enviornmnetal Risk Factors of Crohn’s disease and ulcertive Colitis: an update.Clin Biology.2009 June;33(3)145-147
Karlinger K, Gyorke T, Mako E. The epidemiology and the pathogenesis of Inflammatory bowel disease. European Journal of Radiology 2000 Sept;35(3)154-167