Bachelor School of Nursing, Luigi Sacco Teaching Hospital, University of Milan, Milan, Italy.
San Paolo Bachelor School of Nursing, San Paolo Teaching Hospital, University of Milan, Milan, Italy.
J Clin Nurs. 2017 Dec;26(23-24):5082-5092. doi: 10.1111/jocn.14051. Epub 2017 Sep 29.
To determine and compare the prevalence of malnutrition in medical and surgical hospital units; to assess quality of nutritional care and patients' perception about quality of food and nutritional care.
Hospital malnutrition in older people leads to increased mortality, length of stay, risk of infections and pressure ulcers. Several studies show that malnutrition is often caused by hospitalisation and related to poor nutritional care. Few studies report data on surgical older patients.
A cross-sectional, multicenter study was conducted in 12 hospitals in northern Italy.
Malnutrition prevalence was determined according to the Mini Nutritional Assessment full-version. Head nurses were interviewed in 80 units, through a validated questionnaire regarding quality of nutritional care. Semi-structured interviews were administered to a sample of patients, to investigate their perception about quality of food and nutritional care.
Two hundred twenty-eight patients of 1,066 were malnourished (21.4%). Medical patients were at higher risk, so were women, patients aged 85 or more, with impaired autonomy, pressure ulcers or taking more than three drugs. The lack of personnel impacts on quality of care: in 55% of the units, no nutritional screening is performed; nutritional history is investigated in 48% only. No protocols for nutritional problems exist in 70% of the wards; hardly ever the intake is measured. Patients are mostly satisfied, even though they report that food has no taste and is not well presented. They remark the need for more personnel.
Prevalence was high, as found in other studies. Medical patients were at higher risk. Nutritional care was inadequate, and often no measures were adopted to prevent malnutrition. Staffing should be increased during meals.
These findings will provide indications on the strategies needed to overcome such barriers.
确定和比较医疗和外科医院病房的营养不良患病率；评估营养护理质量以及患者对食物和营养护理质量的看法。
老年人医院营养不良会导致死亡率、住院时间、感染风险和压疮增加。多项研究表明，营养不良通常是由住院引起的，并与营养护理不佳有关。很少有研究报告关于老年外科患者的数据。
在意大利北部的 12 家医院进行了一项横断面、多中心研究。
根据 Mini Nutritional Assessment 全版本确定营养不良的患病率。通过验证后的问卷对 80 个病房的护士长进行了关于营养护理质量的访谈。对患者样本进行了半结构化访谈，以调查他们对食物和营养护理质量的看法。
在 1066 名患者中，有 228 名患者营养不良（21.4%）。与其他研究结果一致，医疗患者的风险更高，女性、85 岁或以上的患者、自理能力受损、有压疮或服用三种以上药物的患者风险更高。人员短缺会影响护理质量：55%的病房没有进行营养筛查；只有 48%的病房会调查营养史。70%的病房没有营养问题的方案；几乎从不测量摄入量。患者大多感到满意，尽管他们表示食物没有味道，也不好看。他们提到需要更多的人手。
患病率与其他研究一样高，医疗患者的风险更高。营养护理不足，通常也没有采取任何措施来预防营养不良。在就餐期间应增加人员配备。
这些发现将为克服这些障碍提供所需的策略指示。
