Effectiveness of individualised nutritional care plans to reduce malnutrition during hospitalisation and up to 3 months post-discharge: a systematic scoping review

Abstract

ObjectivesThe prevalence of malnutrition after hospitalisation is reported to be 20%–45%, which may lead to adverse outcomes, as malnutrition increases the risk of complications, morbidity, mortality and loss of function. Improving the quality of nutritional treatment in hospitals and post-discharge is necessary, as hospital stays tend to be short. We aimed to identify and map studies that assess the effectiveness of individualised nutritional care plans to reduce malnutrition during hospitalisation and for the first 3 months post-discharge.DesignThis was a systematic scoping review.MethodsWe systematically searched for all types of studies in the following databases: EMBASE, MEDLINE via PubMed, and the Cumulative Index to Nursing and Allied Health Literature, with no restriction on data or publication language. We also reviewed the reference lists of the included studies. The abstracts and full articles were simultaneously screened by two independent reviewers. Differences of opinion were discussed among the two investigators, and a third reviewer assisted with the discussion until consensus was reached. Studies in which the patients received an individual nutritional care plan related to their hospital stay and were followed up post-discharge were included. We then conducted a thematic content analysis of the extracted literature.ResultsNine randomised controlled trial studies met the inclusion criteria: six were conducted in Scandinavian countries. All studies were mainly conducted among elderly patients (mean ages varied from 75 to 88 years). The review studies measured 10 different outcomes; the most common outcomes were nutritional status and readmission. Six studies reported one or more significant positive intervention effect. Inconsistent results were identified for four outcome variables.ConclusionsIndividualised nutritional care plans and follow-up home visits might improve patients’ nutritional status. However, there is need for a systematic review that assesses study quality and extends the time to 6 months post-discharge.

Hubungan Mutu Asuhan Gizi Dengan Lama Rawat Inap Pasien Di Rumah Sakit Islam Ibnu Sina Bukittinggi

“…32 Pemberian asuhan gizi akan mempengaruhi kemampuan makan pasien dan mempercepat penyembuhan penyakit sehingga akan mempengaruhi waktu rawat inap pasien. 33 Penelitian Abrha et al (2019) menjelaskan beberapa faktor yang akan mempengaruhi lama rentang waktu lama rawat inap pasien pada rumah sakit umum di Ethiopia. Dari hasil penelitian ini didapatkan pasien dengan IMT normal memilki lama rawat inap lebih pendek dibandingkan pasien dengan IMT kurus.…”

Campanha: 16 passos para a desospitalização segura

“…Pacientes desnutridos apresentam aumento nas complicações clínicas, retardando o processo de alta. Esses pacientes também têm uma maior readmissão na unidade hospitalar e, consequentemente, causam aumento nos custos em saúde 5,6 .…”

“…Para que todo esse processo ocorra de forma eficaz, é de extrema importância que os profissionais envolvidos estejam cientes das dificuldades e obstáculos que o paciente, seus cuidadores e familiares possam vivenciar fora do ambiente hospitalar. A comunicação com profissionais de saúde responsáveis pelo seguimento desses pacientes também auxilia a agrupar informações essenciais ao processo assistencial fora do ambiente hospitalar, dando continuidade aos cuidados necessários, para atingir as metas nutricionais traçadas durante toda a internação 5,30 .…”

HOMEFOOD randomized trial—beneficial effects of 6-month nutrition therapy on body weight and physical function in older adults at risk for malnutrition after hospital discharge

“…The use of ONS is another way to improve nutritional status but meta-analyses of such interventions have only shown modest benefits with respect to weight gain (~1.0 kg) and improvements in nutritional status [9]. However, there is some suggestion that inclusion of dietary counselling in such interventions might increase efficacy of these two outcomes [8,[10][11][12][13][14][15].…”