Hospital Care / INPAC

"Food Is Medicine" is more than just a slogan. It's a belief. It is an approach to care. It represents a tremendous amount of research that identifies the process changes we can make to improve nutrition within our healthcare institutions.

The Integrated Nutrition Pathway for Acute Care (INPAC) is a pathway that supports the detection, prevention and treatment of malnutrition. Key activities to reach these goals are: malnutrition screening; assessment to diagnose malnutrition; standard care to ensure all patients can access their food and have sufficient food they can eat; monitoring to ensure patients are improving; advanced care strategies to promote food intake with focused treatments; and specialized care, provided by a nutrition professional.

INPAC and the INPAC Toolkit

INPAC is an evidence and consensus based algorithm developed by Canadian clinicians and researchers to detect, monitor, and treat malnutrition in acute care patients. INPAC is considered a minimum standard to meeting the nutritional needs of patients.

The INPAC Toolkit provides the knowledge and tools needed to take practical steps that will lead to big nutritional change for hospital patients.

Explore each INPAC activity in more detail: 

Nutrition risk screening is the first step in identifying patients at risk for malnutrition. It is the first step of the Integrated Nutrition Pathway for Acute Care (INPAC) and ensures that detection of all malnourished (medical and surgical) patients occurs within 24 hours of admission.

Assessment (SGA)
Patients identified to be at nutrition risk require a diagnosis to confirm malnutrition. Subjective global assessment (SGA) is the gold standard for diagnosing malnutrition. SGA is a simple bedside method used to diagnose malnutrition and identify those who would benefit from nutrition care.

Standard Care
Standard care refers to the minimum level of care that should be received by all patients, regardless of their nutritional status.

Monitoring Patients
Malnutrition can develop quickly in hospital, so it is important that food intake and body weight monitoring occurs for all patients.

Advanced Care
Many hospitals already have available processes for promoting energy and protein dense food intake (e.g. prescribed diets, nourishments) to treat malnutrition. 

Discharge Planning
Patients who are identified to be malnourished (SGA B or C) and who do not fully recover their nutritional status during their admission, require ongoing care in the community.

Auditing Practice
These questionnaires, surveys and audit tools have been used in research but are also designed to be used in your practice to identify where change is needed, as well to evaluate an intervention.

© 2021 Canadian Malnutrition Task Force