Rahman Adam, Wu Thomas, Bricknell Ryan, Muqtadir Zack, Armstrong David
Department of Medicine, Division of Gastroenterology, Western University, London, Canada
Department of Medicine, Division of Gastroenterology, Western University, London, Canada.
Nutr Clin Pract. 2015 Oct;30(5):709-13. doi: 10.1177/0884533615598954. Epub 2015 Aug 7.
Malnutrition is common in Canadian hospitalized patients, yet system-wide malnutrition screening is not mandatory in Canada.
Our goal was to define the point prevalence of malnutrition risk at a major tertiary care center in Hamilton, Ontario, using the Malnutrition Universal Screening Tool (MUST) to determine feasibility of hospital-wide screening in the Canadian context.
After research ethics approval was obtained, we arranged for a clinical nutrition support team to conduct the MUST screening on all inpatients at Hamilton Health Sciences, Juravinski site, a large academic acute care hospital.
A total of 315 patients were included (female, n = 160 [51%]; male, n = 155 [49%]; average age, 71 years). We identified 31% at high risk for malnutrition and 14% at medium risk, keeping with reported rates of malnutrition in the literature. Survey of dietitians and interns indicated that the MUST was easy to use and perform and that they had support of their unit supervisors. All respondents thought that the screen was useful and they wanted to repeat it.
The MUST is an easy and efficient way to define point prevalence of malnutrition risk in Canadian hospitalized patients. Moving to system-wide nutritional screening will bring about the best practices in nutrition care with the involvement of key stakeholders and decision makers. Nutritional screening will allow us to utilize nutrition resources more efficiently, engage administrators in addressing shortfalls in nutrition care, and form a baseline for which to measure the efficacy of future nutritional interventions.
营养不良在加拿大住院患者中很常见，但在加拿大，全系统的营养不良筛查并非强制性要求。
我们的目标是在安大略省汉密尔顿的一家大型三级医疗中心，使用营养不良通用筛查工具（MUST）来确定营养不良风险的现患率，以评估在加拿大背景下进行全院筛查的可行性。
在获得研究伦理批准后，我们安排了一个临床营养支持团队对汉密尔顿健康科学中心朱拉温斯基院区（一家大型学术性急症护理医院）的所有住院患者进行MUST筛查。
共纳入315例患者（女性160例[51%]；男性155例[49%]；平均年龄71岁）。我们发现31%的患者存在高营养不良风险，14%的患者存在中度风险，与文献报道的营养不良发生率相符。对营养师和实习生的调查表明，MUST易于使用和操作，且得到了所在科室主管的支持。所有受访者都认为该筛查有用，并希望重复进行。
MUST是确定加拿大住院患者营养不良风险现患率的一种简便有效的方法。转向全系统的营养筛查将在关键利益相关者和决策者的参与下带来营养护理的最佳实践。营养筛查将使我们能够更有效地利用营养资源，促使管理人员解决营养护理方面的不足，并形成一个衡量未来营养干预效果的基线。
