520 / Nutritional screening

SPAIN
Classification of the PSP
Type of Patient Safety Practice Not Evaluated
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Malnutrition
There is no specified text here There is no specified text here
Topic of the reported practice
Clinical guidelines or pathways
Aim and the benefit of the Patient Safety Practice
 
Malnutrition in the elderly is a common health problem. Studies in our country show a prevalence of malnutrition of 3.3% in the elderly living at home and from 7.7 to 26% in the institutionalized. However, the problem becomes more prevalent in the hospital. At this time, patients over age 65 account for over 50% of the hospitalized population and more than half of the hospitalized elderly show some degree of malnutrition on admission or develop nutritional deficits during their stay in hospital. Malnutrition, becomes often a side effect of hospitalization in this age group. The basic tools for the prevention and treatment of hospital malnutrition are early detection and the establishment of effective nutrition actions.
Description of the Patient Safety Practice
 
Objective:
To evaluate the nutricional status of the elderly hospitalized patient with the Mini Nutritional Assessment ,its relationship with length of hospital stay and mortality, the incidence of malnutrition during hospitalization and to evaluate the applicability of MNA in an Internal Medicine Department of an acute care hospital.
Material and methods: A prospective study on the nutritional status of patients of 65 years or older admitted to hospital in an Internal Medicine Department was performed in 106 consecutive patients. In all patients a MNA test, an anthropometric (weight, height, body mass index, skinfold), and biochemical (cholesterol, lymphocytes, albumin) evaluation were performed; outcome, age, institutionalization, Charlson index and Barthel index were recorded. Results: Mean age of thepatients was 81,77 years, Charlson index 2.3 +/-1.9 and Barthel index 74.9 +/-30.8. Mean weight was 64.5 +/-10.6 kg, BMI 26 +/- 3.9, and weight loss in the previous 3 months 1.17 +/-2.92 kg. Mean length of hospital stay was 11.1 +/-9.8, and mortality was 5.7%. Prevalence of malnutrition, assessed by MNA, was 4.7% , and 36.8% of the patients were at risk of malnutrition. Malnourished patients have a longer length of hospital stay, higher Barthel and Charlson indexes.There are no conclusive differences in mortality. Incidence of malnutrition during hospitalization was between 2.43 and 15.68%.
Conclusions: Malnutrition increases length of hospital stay ,rate of complications and costs. The clinicians responsable for the patient should perform nutrition evaluation at hospital admission and repeat it during the hospitalization, using simple screening tools that incorporate an explicit nutrition intervention plan.
Attachment of relevant written information and/or photos, as appropriate
582_WP4_MNA_spanish.zip
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, partly
Level of implementation of reported practice
Team level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
No
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
582_WP4_articulo nutrición RCE largo.pdf
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Not known
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Health care assistants
Dieticians/ Nutritionists
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Yes
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
Patient(s)
Relative(s)
Point of time in which service user or their reprasentatives' involvement takes place
During the development of the Patient Safety Practices
During implementation of the Patient Safety Practices
During evaluation of the Patient Safety Practices
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
No
Short description of the service users' level of involvement
User-led, where the service users control the development and implementation of the PSP
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Lack of incentive
No motivation among staff
Not sufficient human resources available
Staff or management did not recognise the need for change
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
There is no specified text here
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
Yes
Description of used incentives, if any.
The incentives were: to participate in a research project funded by the Ministry of Health, to obtain funds to purchase a chair-bascule scale for the unit, and to be co-author in a original scientific paper.
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Luis Angel Sánchez
Country: SPAIN
Organisation: Hospital Clínico Universitario de Valladolid, Castile and León
E-mail: lsanchezmunoz@gmail.com
Phone: There is no specified text here
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