Semi-automation of nutritional risk screening in the hospital results in systematic scoring

Authors : J. Fournier, M. Coutaz, H. Hertzog, P. Piccot, J. Lamon, M.M. Berger

Summary

Background

Hospital malnutrition is a costly phenomenon as it contributes to complicate and prolong hospital stays. Optimal care of malnutrition requires the identification of patients at risk with an early screening: the latter is not systematically carried out due to lack of specific education, but also of time and user-friendly tools. The aim was to achieve a systematic nutritional screening of all hospital patients and to increase the recording of the diagnosis in the discharge letter.

Methods

Multidisciplinary work group to create nutrition protocols and equivalences between three patient assessment tools: nursing ePA-AC, nutritional risk screening (NRS) and Mini Nutritional Assessment (MNA-SF); mapping of the related variables of the 3 tools. Validation by the physician of automatically generates score triggers a dietician visit. Validation of malnutrition by the dietician prompts malnutrition diagnosis proposal for the discharge letter.

Results

After the pilot phase, NRS or MNA-SF scores are now available in all patients of the 2 first implementation sites (geriatry, surgery). Assessment of the patients stress level generated difficulties (over-scoring) that required additional teaching. Doctor validation of pathological scores has increased request for dietician visits. Economical impact of increased diagnosis in discharge letter is yet to come.

Conclusion

The semi-automation of nutritional risk screening is possible without increasing the nurse workload, by mapping their nursing activities to specific nutrition scores adapted to the patient age. The increased diagnosis of malnutrition within 48 h of the hospital admission should lead to better care and optimize hospital reimbursement.

Keywords

Hospital malnutrition; Screening tool; Computerized system; Cost

Citation: J. Fournier, M. Coutaz, H. Hertzog, P. Piccot, J. Lamon, M.M. Berger Semi-automation of nutritional risk screening in the hospital results in systematic scoring doi:10.1016/j.yclnex.2016.05.001

Received: 5 April 2016 Accepted: 2 May 2016 Available online: 13 May 2016

Copyright: © 2016 The Authors.Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism.This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Funding

Unrestricted grant (115′000 CHF) from the industry constituted by donations from Nestlé Suisse SA, BBraun Schweiz, Abbott Schweiz, and Fresenius Kabi AG Schweiz supporting the project 2014?2015.

Conflict of interest

See funding statement above.

Acknowledgements

The authors are grateful for strong administrative support from the General Direction of the HVS and its General Director Prof Eric Bonvin. We would also like to thank the nutrition industry and their product managers for supporting the project: Mrs. Andrea Plieninger and Mrs. Aude Germanier for Nestlé HealthCare Nutrition (Nestlé Suisse SA, Vevey), followed by Mrs. Madeleine Stöckli and Mr. Werner Vogel for BBraun Schweiz AG, Mr. Roger Muller for Abbott Schweiz, and finally Mr. Niklaus Hutmacher for Fresenius Kabi AG Schweiz.