Undiagnosed Malnutrition in Hospitalized Patients Leads to Slower Healing, Higher Costs
September 28, 2015, Silver Spring, MD – Today, the first day of Malnutrition Awareness Week™, a new article from the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), published in The Joint Commission Journal on Quality and Patient Safety, indicates that the impact and scope of disease-related malnutrition argues for its importance as a serious safety issue. The article calls for the establishment of a national goal in the United States.
“A national goal, combined with a series of specific actions to address disease-related malnutrition, has the potential to improve patient outcomes by reducing readmissions, morbidity, mortality, and costs,” said Gordon Jensen, MD, Ph.D. Professor and Head of Nutritional Sciences at The Pennsylvania State University and one of the article’s authors, all of whom serve on the A.S.P.E.N. Malnutrition Committee. “It is our aim to mobilize health care stakeholders to implement effective, team-based care processes that monitor and improve the nutrition care of hospitalized patients.”
It is estimated that at least one third of patients in developed countries are malnourished upon admission to the hospital, yet the condition continues to be under-diagnosed across the United States. If left untreated, approximately two thirds of those patients will experience a further decline in their nutrition status during their hospitalization. Malnutrition also is associated with an increased risk of pressure ulcers and impaired wound healing, immune suppression and higher infection rates, higher treatment costs, and increased mortality. It leads to longer hospital stays and the risk of readmission. In addition to the human cost, there is a significant economic cost as well – as much as $156.7 billion per year.
“The need for healthcare teams to recognize the value of clinical nutrition care and promptly identify at-risk patients upon admission is vital,” said Debra BenAvram, A.S.P.E.N. CEO. “We know that nutrition interventions significantly reduce complication rates, length and cost of stay, readmission rates, and, in some studies, mortality.”
A.S.P.E.N.’s article points to the growing evidence that nutrition intervention is an effective strategy for prevention of health care–acquired malnutrition and associated complications. It proposes three key actions organizations should take to address prevention or treatment of acute or chronic disease-related malnutrition in hospitalized patients:
Each clinician on the interdisciplinary care team should participate in the execution of the nutrition care plan.
Develop systems to quickly diagnose all malnourished patients and those at risk. If malnutrition is present, it should be included as one of the patient’s coded diagnoses.
Develop nutrition care plans within 48 hours of identification of malnutrition and implement comprehensive nutrition interventions such as education and counseling; coordination of nutrition care; and nutrition delivery, which can range from provision of nutrient-dense food to enteral and parenteral nutrition.
“While it is not likely that malnutrition will become a ‘never event,’ the absence of timely nutrition assessment, diagnosis, and implementation of a care plan in patients at risk for or with preexisting malnutrition should be a ‘never event,’” said Jensen. “Malnutrition should never result from a lack of attention from clinicians or hospital resources.”
The release of the article coincides with Malnutrition Awareness Week™, which begins nationwide today.
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The Joint Commission is an independent, not-for-profit organization that accredits and certifies more than 20,500 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards. Visit www.jointcommission.org to learn more.
The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) is dedicated to improving patient care by advancing the science and practice of nutrition support therapy and metabolism. Founded in 1976, A.S.P.E.N. is an interdisciplinary organization whose members are involved in the provision of clinical nutrition therapies, including parenteral and enteral nutrition. With more than 6,000 members from around the world, A.S.P.E.N. is a community of dietitians, nurses, nurse practitioners, pharmacists, physicians, scientists, students, and other health professionals from every facet of nutrition support clinical practice, research, and education. For more information about A.S.P.E.N., please visit http://www.nutritioncare.org.