Malnutrition Care for All - Addressing malnutrition across all healthcare settings

References

These references support the data presented in the infographic “Addressing malnutrition across all healthcare settings".  

Malnutrition prevalence in hospitalized patients

• Adults-up to 1 in 2 adults¹
• Pediatrics- Up to 1 in 3 pediatric patients admitted to tertiary hospital^2,3

Malnutrition is costly

• Cost of $2 billion per year⁴
• Malnourished patients stay average 3 days longer in hospital⁴ 

Poor food intake is a reality 

• Older adults in community-1 in 3 older adults has difficulty meeting nutritional needs⁵
• Adults in hospital-30% adults eat less than half their food¹
• Pediatrics in hospital-1 in 4 peds meets less than 50% energy needs²

Weight Loss

• Adults-greater than 5% weight loss associated with longer hospital stay⁶ 
• Adults post hospital discharge-1 in 4 reports weight loss⁷
• Pediatrics in hospital-1 in 5 peds patients lose more than 5% body weight²

1. Allard JP, Keller H, Jeejeebhoy KN, Laporte M, Duerksen D, Gramlich L, Payette H, Bernier P, Vesnaver E*, Davidson B, Terterina A, Lou W. Malnutrition at hospital admission: contributors and impact on length of stay. A prospective cohort study from the Canadian Malnutrition Task Force. J Parenter Enteral Nutr. 2016; 40(4): 487-497. doi 10.1177/0148607114567902
2. Bélanger V, McCarthy A, Marcil V, Marchand V, Boctor DL, Rashid M, Noble A, Avinashi V, Davidson B, Groleau V, Spahis S, Levy E. Assessment of Malnutrition Risk in Canadian Pediatric Hospitals: A Multicenter Prospective Cohort Study. J Pediatr. 2019 Feb;205:160-167.e6. https://doi.org/10.1016/j.jpeds.2018.09.045
3. Carter L, Klatchuk N, Sherman K ,Thomsen P, Mazurak V, Brunetwood MK. Barriers to Oral Food Intake for Children Admitted to Hospital. Canadian Journal of Dietetic Practice and Research, 2019, 80(4): 195-199. https://doi.org/10.3148/cjdpr-2019-012
4. Curtis L, Bernier P, Jeejeebhoy K, Allard JP, Duerksen D, Gramlich L, Laporte M, Keller H. Costs of hospital malnutrition. Clinical Nutrition. 2017; 36(5): 1391-1396. https://doi.org/10.1016/j.clnu.2016.09.009
5. Ramage-Morin P, Garriguet D.  Nutritional risk among older Canadians, Statistics Canada, Catalogue no. 82-003-X, Health Reports, 2013;24( 3): 3-13.
6. Allard JP, Keller H, Jeejeebhoy KN, Laporte M, Duerksen DR, Gramlich L, Payette H, Bernier P, Davidson B, Teterina A, Lou W. Decline in nutritional status is associated with prolonged length of stay in hospitalized patients admitted for 7 days or more: a prospective cohort study. Clinical Nutrition. 2016 Feb;35(1):144-152. https://doi.org/10.1016/j.clnu.2015.01.009
7. Keller H, Laporte M, Payette H, Allard J, Bernier P, Duerksen D, Gramlich L,  Jeejeebhoy K. Prevalence and predictors of weight change post discharge from hospital: a study of the Canadian Malnutrition Task Force. Eur J Clin Nutr. 2017 Jun;71(6):766-772. https://doi.org/10.1038/ejcn.2016.277

Resources

The following resources have been developed by CMTF teams and the Pediatric, Primary & Community Care, and the Food & Long Term Care Working Groups. Aimed to assist health care professionals working in hospitals, primary & community care & long term care address malnutrition and improve nutrition care in their respective settings, these are relevant to CMAW 2022 theme of “Malnutrition Care for All”.

Adult Hospital & Acute Care

National Standard on Malnutrition Prevention, Detection and Treatment
Created in collaboration with Health Standards Organization and Canadian Malnutrition Task Force (CMTF)-Canadian Nutrition Society, the CAN/HSO 5066:2021 Malnutrition Prevention, Detection and Treatment Standard is intended to be used by organizations that provide acute care/inpatient services to adults and children.

Subjective Global Assessment Video Collection
CMTFs 2022 collection of videos on how to conduct Subjective Global Assessment (SGA), the gold standard for diagnosing malnutrition in adults.

INPAC
Integrated Nutrition Pathway for Acute Care (INPAC) is a pathway developed by Canadian clinicians and researchers to detect, monitor, and treat malnutrition in hospitalized acute care adult patients. Learn how to adopt INPAC activities which includes an overview presentation on INPAC, behaviour change techniques and models of improvement from the More-2-Eat Study

Pediatric Hospital & Acute Care

P-INPAC 
Pediatric Integrated Nutrition Pathway for Acute Care (P-INPAC) is a evidence-based/consensus-based algorithm developed by Canadian clinicians and researchers and it is based on the model of INPAC, the algorithm used and researched for malnutrition care in adult care settings in Canada. 

Screening
Nutrition screening for paediatric patients which includes who to screen, when, how, which tools to use and other important considerations.

Assessment
Subjective Global Nutrition Assessment (SGNA), the gold standard for diagnosing pediatric malnutrition in hospitals, Standard Anthropometric measurements and more

Primary & Community Care

Malnutrition Toolkit for dietitians to provide hands on tools to help screen, assess and treat malnutrition within primary care, community, and home care. Includes a combination of infographics, evidence based pathways, guidance documents, handouts, and relevant links.

Long Term Care

Resources and infographic for Long Term Care and for Food service in healthcare