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.

INPAC and the INPAC Toolkit

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.

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.



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