Hospital study shows nutritional deficits

UP TO 11 per cent of patients admitted to hospitals in Ireland are malnourished, according to a new Department of Health report published last week.

The Food and Nutrition in Hospitalstudy, which contains a series of guidelines for health professionals, also indicates that 63-84 per cent of admissions are at nutritional risk.

The report says that during their stay in hospital, close to a third of patients show a nutritional decline. This can be attributed to a number of different factors including the need to fast ahead of procedures.

Focusing on patients’ nutritional status is not just important in terms of the welfare of the individual but also on a cost-basis, too.

Studies have shown that the length of time a patient spends in hospital and the cost of that stay is linked to his or her nutritional status.

Undernutrition in patients has been associated with muscle weakness, alterations to function of the gut, delays in wound healing, depression and a reduction of the ability of the immune system to function. Moreover, according to one Irish study, a 10 per cent decline in weight loss has been linked with a significantly greater risk of death.

Meanwhile, a review of 22 nutrition surveys in 70 hospitals in the US showed that patients receiving early nutrition intervention had a shorter length of stay of 2.1 days on average, leading to a direct saving of $697 (€464) per bed per day.

The new guidelines, which have been developed in consultation with the Health Service Executive (HSE), the National Hospitals Office and nutrition experts, are to be distributed to all acute hospitals.

Recommendations in the report include screening of patients for malnutrition on admission to hospital, regular monitoring of dietary intake and modifications to the hospital menu to suit individual patients.

A Department of Health spokeswoman said the new guide- lines were the latest in a series of steps to increase awareness of the serious problem of undernutrition in Irish hospitals.

She told The Irish Timesthat while there were already general healthy eating guidelines promoting low-fat, high-fibre and high fruit and vegetable intake, and low intake of salt and sugar, such diets were inappropriate for most patients and could actually increase undernutrition.

“Such guidelines are aimed at maintaining a healthy weight and helping to prevent long-term diseases such as heart disease. But patients admitted to hospital generally have nutritional needs that would not be met by following such guidelines. They often have higher energy needs or smaller appetites than healthy people, and many patients entering hospital have already lost weight due to their illness,” she said.

Nutritionist Paula Mee has welcomed the new guidelines, but said ensuring that patients were well fed was a role for all hospital staff, not just those working in the canteens.