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

WHAT IS MALNUTRITION

Not being able to use the food that one does eat

Inflammatory bowel

disease

WHAT IS MALNUTRITION

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

HOW TO ENCOURAGE INVOLVEMENT BY

CHANGING THE CULTURE OF YOU HEALTH

SYSTEM

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

QUESTIONS

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