© 2023 Canadian Malnutrition Task Force
Hospital Care / INPAC
Malnutrition in hospitals is a serious concern that is often not detected, diagnosed, or treated. Up to 1 in 2 Canadian adults admitted across 18 hospitals for more than two days were found to be in a malnourished state (Allard et al., 2016). There is a need to take an evidence based approach towards preventing, detecting and treating malnutrition. CMTF has developed a large inventory of evidence based resources and tools to improve care related to hospital malnutrition.
The Integrated Nutrition Pathway for Acute Care (INPAC) is a pathway developed by Canadian clinicians and researchers to detect, monitor, and treat malnutrition in acute care 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.
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 refers to the minimum level of care that should be received by all patients, regardless of their nutritional status.
Malnutrition can develop quickly in hospital, so it is important that food intake and body weight monitoring occurs for all patients.
Many hospitals already have available processes for promoting energy and protein dense food intake (e.g. prescribed diets, nourishments) to treat malnutrition.
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.
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.