Multi-modal intervention improved oral intake in hospitalized patients: A one year follow-up study

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Resumé

BACKGROUND: Good nutritional practice (GNP) includes screening, nutrition plan and monitoring, and is mandatory for targeted treatment of malnourished patients in hospital.

AIMS: To optimize energy- and protein-intake in patients at nutritional risk and to improve GNP in a hospital setting.

METHODS: A 12-months observational multi-modal intervention study was done, using the top-down and bottom-up principle. All hospitalized patients (>3 days) were included. Setting: A university hospital with 758 beds and all specialities. Measurements: Record audit of GNP, energy- and protein-intake by 24-h recall, patient interviews and staff questionnaire before and after the intervention. Interventions: Based on pre-measurements, nutrition support teams in each department made targeted action plans, supervised by an expert team. Education, diagnose-specific nutrition plans, improved menus and eating environment, and awareness were initiated. Statistics: Mann-Whitney and Kruskal-Wallis test was used for ordinal data, and Pearson Chi square test for nominative data.

RESULTS: Overall 545 patients participated (287 before/258 after) from 26/22 departments. There were no significant differences regarding sex, age, BMI or previous weight loss before and after the intervention. Result-indicators: Energy intake improved from 52% to 68% (p < 0.007), and protein intake from 33% to 52% (p < 0.001) (>75% of requirements). Intake of less than 50% of requirements decreased with 50%. Process-indicators: Screening improved from 56% to 77% (p < 0.001), nutrition plans from 21% to 56% (p < 0.0001), and monitoring food intake from 29% to 58% (p < 0.0001).

CONCLUSIONS: Intake of energy and protein as well as GNP improved using a multi-modal top-down and bottom-up approach.

OriginalsprogEngelsk
TidsskriftClinical Nutrition
Vol/bind34
Udgave nummer2
Sider (fra-til)315-322
Antal sider8
ISSN0261-5614
DOI
StatusUdgivet - 2015

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Energy Intake
Eating
Proteins
compound A 12
Chi-Square Distribution
Sex Characteristics
Weight Loss
Interviews
Education
Therapeutics

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title = "Multi-modal intervention improved oral intake in hospitalized patients: A one year follow-up study",
abstract = "BACKGROUND: Good nutritional practice (GNP) includes screening, nutrition plan and monitoring, and is mandatory for targeted treatment of malnourished patients in hospital.AIMS: To optimize energy- and protein-intake in patients at nutritional risk and to improve GNP in a hospital setting.METHODS: A 12-months observational multi-modal intervention study was done, using the top-down and bottom-up principle. All hospitalized patients (>3 days) were included. Setting: A university hospital with 758 beds and all specialities. Measurements: Record audit of GNP, energy- and protein-intake by 24-h recall, patient interviews and staff questionnaire before and after the intervention. Interventions: Based on pre-measurements, nutrition support teams in each department made targeted action plans, supervised by an expert team. Education, diagnose-specific nutrition plans, improved menus and eating environment, and awareness were initiated. Statistics: Mann-Whitney and Kruskal-Wallis test was used for ordinal data, and Pearson Chi square test for nominative data.RESULTS: Overall 545 patients participated (287 before/258 after) from 26/22 departments. There were no significant differences regarding sex, age, BMI or previous weight loss before and after the intervention. Result-indicators: Energy intake improved from 52{\%} to 68{\%} (p < 0.007), and protein intake from 33{\%} to 52{\%} (p < 0.001) (>75{\%} of requirements). Intake of less than 50{\%} of requirements decreased with 50{\%}. Process-indicators: Screening improved from 56{\%} to 77{\%} (p < 0.001), nutrition plans from 21{\%} to 56{\%} (p < 0.0001), and monitoring food intake from 29{\%} to 58{\%} (p < 0.0001).CONCLUSIONS: Intake of energy and protein as well as GNP improved using a multi-modal top-down and bottom-up approach.",
author = "M Holst and T Beermann and Mortensen, {M N} and Skadhauge, {L B} and K Lindorff-Larsen and Rasmussen, {H H}",
note = "Copyright {\circledC} 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.",
year = "2015",
doi = "10.1016/j.clnu.2014.05.001",
language = "English",
volume = "34",
pages = "315--322",
journal = "Clinical Nutrition",
issn = "0261-5614",
publisher = "Elsevier",
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}

TY - JOUR

T1 - Multi-modal intervention improved oral intake in hospitalized patients

T2 - A one year follow-up study

AU - Holst, M

AU - Beermann, T

AU - Mortensen, M N

AU - Skadhauge, L B

AU - Lindorff-Larsen, K

AU - Rasmussen, H H

N1 - Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

PY - 2015

Y1 - 2015

N2 - BACKGROUND: Good nutritional practice (GNP) includes screening, nutrition plan and monitoring, and is mandatory for targeted treatment of malnourished patients in hospital.AIMS: To optimize energy- and protein-intake in patients at nutritional risk and to improve GNP in a hospital setting.METHODS: A 12-months observational multi-modal intervention study was done, using the top-down and bottom-up principle. All hospitalized patients (>3 days) were included. Setting: A university hospital with 758 beds and all specialities. Measurements: Record audit of GNP, energy- and protein-intake by 24-h recall, patient interviews and staff questionnaire before and after the intervention. Interventions: Based on pre-measurements, nutrition support teams in each department made targeted action plans, supervised by an expert team. Education, diagnose-specific nutrition plans, improved menus and eating environment, and awareness were initiated. Statistics: Mann-Whitney and Kruskal-Wallis test was used for ordinal data, and Pearson Chi square test for nominative data.RESULTS: Overall 545 patients participated (287 before/258 after) from 26/22 departments. There were no significant differences regarding sex, age, BMI or previous weight loss before and after the intervention. Result-indicators: Energy intake improved from 52% to 68% (p < 0.007), and protein intake from 33% to 52% (p < 0.001) (>75% of requirements). Intake of less than 50% of requirements decreased with 50%. Process-indicators: Screening improved from 56% to 77% (p < 0.001), nutrition plans from 21% to 56% (p < 0.0001), and monitoring food intake from 29% to 58% (p < 0.0001).CONCLUSIONS: Intake of energy and protein as well as GNP improved using a multi-modal top-down and bottom-up approach.

AB - BACKGROUND: Good nutritional practice (GNP) includes screening, nutrition plan and monitoring, and is mandatory for targeted treatment of malnourished patients in hospital.AIMS: To optimize energy- and protein-intake in patients at nutritional risk and to improve GNP in a hospital setting.METHODS: A 12-months observational multi-modal intervention study was done, using the top-down and bottom-up principle. All hospitalized patients (>3 days) were included. Setting: A university hospital with 758 beds and all specialities. Measurements: Record audit of GNP, energy- and protein-intake by 24-h recall, patient interviews and staff questionnaire before and after the intervention. Interventions: Based on pre-measurements, nutrition support teams in each department made targeted action plans, supervised by an expert team. Education, diagnose-specific nutrition plans, improved menus and eating environment, and awareness were initiated. Statistics: Mann-Whitney and Kruskal-Wallis test was used for ordinal data, and Pearson Chi square test for nominative data.RESULTS: Overall 545 patients participated (287 before/258 after) from 26/22 departments. There were no significant differences regarding sex, age, BMI or previous weight loss before and after the intervention. Result-indicators: Energy intake improved from 52% to 68% (p < 0.007), and protein intake from 33% to 52% (p < 0.001) (>75% of requirements). Intake of less than 50% of requirements decreased with 50%. Process-indicators: Screening improved from 56% to 77% (p < 0.001), nutrition plans from 21% to 56% (p < 0.0001), and monitoring food intake from 29% to 58% (p < 0.0001).CONCLUSIONS: Intake of energy and protein as well as GNP improved using a multi-modal top-down and bottom-up approach.

U2 - 10.1016/j.clnu.2014.05.001

DO - 10.1016/j.clnu.2014.05.001

M3 - Journal article

C2 - 24874177

VL - 34

SP - 315

EP - 322

JO - Clinical Nutrition

JF - Clinical Nutrition

SN - 0261-5614

IS - 2

ER -