MULTIDISCIPLINARY CONSENSUS ON HOSPITAL MALNUTRITION IN SPAIN:
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1 MULTIDISCIPLINARY CONSENSUS ON HOSPITAL MALNUTRITION IN SPAIN: A step forward of the Spanish Society for Parenteral and Enteral Nutrition (SENPE) to its compromise on the fight against malnutrition Grant for the best initiative to fight malnutrition
2 Spanish Society for Parenteral and Enteral Nutrition PREVIOUS WORK Malnutrition Coding Quality Indicators for Nutrition Units
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4 SENPE SEDOM document on coding of hospital malnutrition
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6 Fight Against Malnutrition
7 DIRECTED BY SPONSORED BY PREvalencia de Desnutrición Hospitalaria Y Costes asociados en ESpaña
8 A nationwide, cross sectional study aimed at estimating the prevalence and cost of hospital malnutrition in Spain 1707 patients included in the prevalence malnutrition analysis 470 patients included in the cost of malnutrition analysis
9 Prevalence of malnutrition (NRS2002 3) 23 % 40.0% 37.0% p < 0, % 30.0% 25.0% 20.0% 15.0% 20.7% 25.7% 12.3% 16,7% 25,6% 29,3% 17,0% 10.0% 5.0% 0.0%
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11 Houston, we have a problem
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15 Consensus paper: position statement to fight against hospital malnutrition PROJECT METHODS Literature search SING classification (Scottish Intercollegiate Guidelines Network) Literature review Final recommendations Consensus conference
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17 Recommendations outside hospital setting
18 Recommendations at hospital admission
19 Recommendations during hospitalization INTERVENTION After diagnosis of malnutrition, nutritional requirements definition based on clinical condition and underlying pathology. Inadequate intakes: causes evaluation, systematic inspection and adaptation of menu to personal needs. Prescription of treatment * (oral supplements) if insufficient response to initial dietary intervention. Prescription of treatment* (enteral nutrition) if it persists despite oral intake of dietary intervention and oral supplementation (requires confirmation of GI tract function unaltered). Parenteral nutrition* is reserved if here is contraindication to enteral nutrition or it is insufficient. * Compliance, tolerability and efficacy of treatment will be monitored and recorded
20 The final version of the Consensus Paper was formally presented at the Spanish Ministry of Health
21 Main Achievements Under SENPE leadership, 22 medical societies have participated in a consensus process designed to establish recommendations on the prevention, screening, diagnosis, treatment and monitoring of disease related malnutrition. Formulation of recommendations are based on the best available clinical evidence (based on SIGN criteria). Diversity of participating organizations and huge involvement will facilitate the successful implementation of the recommendations. The Consensus paper will be decisive in extending the importance of fighting against malnutrition across a very wide spectrum of medical practice.
22 Future Plans Improvement in the basic education of clinical nutrition for doctors and nurses in Primary Care, Nurses Homes and Hospital. Make a slide kit with the most important concepts. Incorporation of nutritional assessment in electronic medical records. Mandatory screening and nutritional assessment as part of quality criteria of all health-care settings in Spain. Strategic plan to involves local health authorities. Without -Malnutrition Hospitals Network
23 Thanks to all professionals, specialists, scientific societies, patients and authorities for their enthusiastic involvement in this project and all members of the MNI for this award
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