Multidisciplinary Nutrition Care: Benefitting Patients with Malnutrition Across Healthcare Sectors

Keller, Heather; Slaughter, Sarah; Gramlich, Leah; Namasivayam-MacDonald, Ashwini; Bell, Jack J.

doi:10.1007/978-3-030-63892-4_13

Cited by 4 publications

(6 citation statements)

References 43 publications

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“…For example, they thought GPs, nurses, pharmacists, community‐based assessors/case workers and home support workers were ideally placed to conduct nutrition screening given their frequent interactions with clients. Previous studies reporting on screening interventions involving multidisciplinary healthcare professionals have found that with targeted engagement and training, healthcare professionals generally felt confident in their ability to conduct nutrition screening and first‐line treatment strategies 32–35 . These studies report that implementing nutrition screening in the community was feasible and acceptable to healthcare professionals when accompanied by appropriate nutrition care pathways.…”

Section: Discussionmentioning

confidence: 96%

“…Previous studies reporting on screening interventions involving multidisciplinary healthcare professionals have found that with targeted engagement and training, healthcare professionals generally felt confident in their ability to conduct nutrition screening and firstline treatment strategies. [32][33][34][35] These studies report that implementing nutrition screening in the community was feasible and acceptable to healthcare professionals when accompanied by appropriate nutrition care pathways. Hence, adopting a multidisciplinary approach in primary care, whereby healthcare professionals share responsibility for identifying malnutrition and frailty, may help improve client outcomes in the community.…”

Section: Discussionmentioning

confidence: 99%

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Dietitians' perceptions of identifying and managing malnutrition and frailty in the community: A mixed‐methods study

Roberts

Gomes

Rattray

2023

Nutrition & Dietetics

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AimThis study aimed to explore dietitians' perceptions of their current practice for identifying and managing malnutrition/frailty in the community, to fill an evidence gap.MethodsThis mixed‐methods study involved an online survey distributed to dietitians practising in Australia and New Zealand, and semi‐structured interviews with a subset of survey participants. The 34‐item survey and interviews explored dietitians' practices for identifying/managing malnutrition and frailty, focusing on the community setting. Survey data were analysed descriptively and some simple association tests were conducted using statistical software. Interview data were analysed thematically.ResultsOf the 186 survey respondents, 18 also participated in an interview. Screening and assessment for malnutrition varied in the community and occurred rarely for frailty. Dietitians reported practising person‐centred care by involving clients/carers/family in setting goals and selecting nutrition interventions. Key barriers to providing nutrition care to community‐dwelling adults included a lack of awareness/understanding of nutrition by clients and other health professionals (leading to them not participating in or valuing nutrition care), lack of time and resources in the community, and client access to foods/supplements. Enablers included engaging family members/carers and coordinating with other health professionals in nutrition care planning.ConclusionReported practices for identifying malnutrition and frailty vary in the community, suggesting guidance may be needed for health professionals in this setting. Dietitians reported using person‐centred care with malnourished and frail clients but encountered barriers in community settings. Engaging family members/carers and multidisciplinary colleagues may help overcome some of these barriers.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Dietitians' perceptions of identifying and managing malnutrition and frailty in the community: A mixed‐methods study

Roberts

Gomes

Rattray

2023

Nutrition & Dietetics

View full text Add to dashboard Cite

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“…Ideally, dietitians work within multidisciplinary teams that include other allied health professionals to address these issues. However, dietitians who work in LTC need to develop additional competencies to help meet these needs due to a scarcity of other qualified health professionals (e.g., speech language pathologists, dentists) who could potentially address these challenges 27,43,44 . Considering the results of a comprehensive study of Canadian LTC residents, which estimated the prevalence of dysphagia risk in nearly 60% of residents, poor oral health in almost half of residents and poorly fitting dentures in nearly one third of residents, 45 dietitians are invaluable despite limited funding allocation for their services 18 .…”

Section: Discussionmentioning

confidence: 99%

“…This study is part of a larger study intended to understand the nutrition care experience for LTC residents in the last 6 months of life, which has already established that eating challenges increase in severity and complexity with proximity to death 26 . Apart from routine assessments, dietitian involvement for new or worsening eating challenges among residents is often contingent on referrals from a multidisciplinary team of care providers, most often nursing staff 1,27 . However, the circumstances around such referrals (e.g., frequency, reasons for referral, resulting interventions) as they relate to the end‐of‐life decline of residents in current practice are unclear.…”

Section: Introductionmentioning

confidence: 99%

“…26 Apart from routine assessments, dietitian involvement for new or worsening eating challenges among residents is often contingent on referrals from a multidisciplinary team of care providers, most often nursing staff. 1,27 However, the circumstances around such referrals (e.g., frequency, reasons for referral, resulting interventions) as they relate to the end-of-life decline of residents in current practice are unclear. As such, the overall aim of this current investigation is to gain a better understanding of dietitian involvement in LTC resident's end-of-life care via referrals.…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with dietitian referrals to support long‐term care residents advancing towards the end of life

Morrison‐Koechl,

Heckman,

Banerjee

et al. 2024

J Human Nutrition Diet

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BackgroundDietitians are central members of the multidisciplinary long‐term care (LTC) healthcare team. The overall aim of this current investigation is to gain a better understanding of dietitian involvement in LTC resident's end‐of‐life care via referrals.MethodsRetrospective chart reviews for 164 deceased residents (mean age = 88.3 ± 7.3; 61% female) in 18 LTC homes in Ontario, Canada, identified dietitian referrals and documented eating challenges recorded over 2‐week periods at four time points (i.e., 6 months, 3 months, 1 month and 2 weeks) prior to death. Nutrition care plans at the beginning of these time points were also noted. Logistic mixed effects regression models identified time‐varying predictors of dietitian referrals. Bivariate tests identified associations between nutrition orders and dietitian referrals that occurred in the last month of life.ResultsNearly three‐quarters (73%) of participants had at least one dietitian referral across the four observations. Referrals increased significantly with proximity to death; 45% of residents had a referral documented in the last 2 weeks of life. Dietitian referrals were associated with the number of eating challenges (odds ratio [OR] = 1.42, 95% confidence interval [CI] = 1.27, 1.58). Comfort‐focused nutrition care orders were significantly more common when a dietitian was referred (25%) compared with when a dietitian was not referred (12%) in the final month of life (p = 0.04).ConclusionsOur findings suggest that dietitians are involved in end‐of‐life and comfort‐focused nutrition care initiatives, yet they are not engaged consistently for this purpose. This presents a significant opportunity for dietitians to upskill and champion palliative approaches to nutrition care within the multidisciplinary LTC team.

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Underlying Causes and Co-existence of Malnutrition and Infections: An Exceedingly Common Death Risk in Cancer

et al. 2022

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In nutrition science, malnutrition is a state of imbalance between intake and the needs of the organism, leading to metabolic changes, impaired physiological functions, and weight loss. Regardless of the countless efforts being taken and researched for years, the burden of malnutrition is still alarming and considered a significant agent of mortality across the globe. Around 45% of 12 million children deaths (0–5 years old) annually are due to malnutrition, mostly from developing countries. Malnutrition develops associations with other infections and leads to substantial clinical outcomes, such as mortality, more visits to hospitals, poor quality of life and physical frailty, and socioeconomic issues. Here, in this review, we intend to provide an overview of the current burden, underlying risk factors, and co-existence of malnutrition and other infections, such as cancer. Following the rising concern of the vicious interplay of malnutrition and other medical illnesses, we believed that this narrative review would highlight the need to re-make and re-define the future strategies by giving comprehensive and sustainable programs to alleviate poverty and combat the rampant infectious diseases and those nutrition-related health problems. Furthermore, the study also raises the concern for hospitalized malnourished cancer patients as it is crucially important to knowledge the caregiver healthcare staff for early interventions of providing nutritional support to delay or prevent the onset of malnutrition.

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Multidisciplinary Nutrition Care: Benefitting Patients with Malnutrition Across Healthcare Sectors

Cited by 4 publications

References 43 publications

Dietitians' perceptions of identifying and managing malnutrition and frailty in the community: A mixed‐methods study

Dietitians' perceptions of identifying and managing malnutrition and frailty in the community: A mixed‐methods study

Factors associated with dietitian referrals to support long‐term care residents advancing towards the end of life

Underlying Causes and Co-existence of Malnutrition and Infections: An Exceedingly Common Death Risk in Cancer

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