Aktuelle Ernährungsmedizin 2015; 40 - O2_1
DOI: 10.1055/s-0035-1550171

Improving Nutritional Risk Management at a tertiary Swiss Hospital Center of General Internal Medicine: A pre-post intervention study

C Aeberhard 1, M Perrig 2, ML Joray 1, S Mühlebach 3, Z Stanga 1, 2
  • 1Department of Endocrinology, Diabetes and Clinical Nutrition, University Hospital, Bern, Switzerland
  • 2Department of General Internal Medicine, University Hospital, Bern, Switzerland
  • 3Division of Clinical Pharmacy and Epidemiology and Hospital Pharmacy, University of Basel, Switzerland

Introduction: Managing patients' nutritional risk is important in the hospital setting. Malnutrition often goes undetected and therefore untreated. The general goal of the present study was to improve malnutrition awareness and management at our department. The objectives were to assess whether an easylearn educational program leads to an increased knowledge of basics in nutrition and behavioural changes toward better malnutrition management, and therefore to more frequent nutritional therapies [1,2].

Methods: Single centre prospective pre-post intervention study. Nutritional screening (NRS 2002) and prescription of nutritional therapies were assessed in pre- and post-intervention phases. Parallel, all physicians of the department of general internal medicine had to fill a questionnaire about basic nutritional knowledge before and after the easylearn program (intervention).

Results: 342 patients were included in the pre-intervention and 300 in the post-intervention phase. In the pre-intervention phase 54.09% were at nutritional risk (NRS ≥3) and in the post intervention phase 61.67%. Only 18.71% of the included patients in the pre-intervention phase and 17.0% of the patients in the post-intervention phase had an adequate nutritional therapy. Forty-nine resp. 41 physicians filled in the questionnaire before and after the intervention. The mean of correct answers was 55.62% resp. 59.43%.

Conclusions: The educational intervention showed only a slight improvement in nutritional knowledge, reflected by the questionnaire filled out and the number of prescriptions of nutritional therapies in patients at risk, despite the high rate of malnourished patients. The easylearn program did not allow to achieve behavioral changes in malnutrition awareness and management in physicians. Further research is needed to improve significantly the knowledge in nutritional basics and the malnutrition management skills of young physicians. Additional well-structured educational and validated didactical activities as bedside teaching, life teaching sessions, clinical skills training, problem based learning have to be applied.

Keywords: malnutrition – nutritional risk – educational intervention

References:

[1] Mowe M, Bosaeus I, Rasmussen HH et al. The Scandinavian Nutrition Group. Insufficient nutritional knowledge among health care workers? Clin Nutr 2008;27:196 – 202.

[2] Rassmussen HH, Kondrup J, Staun M, et al. A method for implementation of nutritional therapy in hospitals. Clin Nutr 2006;25:515 – 523.