营养不良的成年人接受医院出院营养护理指导的情况：一项试点研究。

Malnourished adults' receipt of hospital discharge nutrition care instructions: a pilot study.

机构信息

Christiana Care Value Institute, Newark, DE, USA.

Department of Medicine, Christiana Care Health System, Christiana Care Value Institute, Newark, DE, USA.

出版信息

J Hum Nutr Diet. 2019 Oct;32(5):659-666. doi: 10.1111/jhn.12662. Epub 2019 Apr 29.

DOI:10.1111/jhn.12662

PMID:31037779

Abstract

BACKGROUND

Malnutrition remains an important yet under-recognised problem among hospitalised adults. Although interventions exist aiming to improve nutritional status beyond hospitalisation, few studies examine how often and what type of nutrition care instructions are given at discharge. The present study sought to review nutrition-focused discharge care provided to malnourished adults.

METHODS

We reviewed the electronic medical record for discharge nutrition care instructions provided to adult patients identified by dietitians as malnourished over a 4-month period.

RESULTS

Seventy-six eligible patients were identified during the study period. More than half of malnutrition cases (64.5%) were attributed to chronic illness. According to electronic medical record documentation, 6.6% received discharge instructions to consume oral nutrition supplements and 30.3% received new or changed prescriptions for vitamins/noncaloric supplements. Almost half of patients (47.4%) received general diet instructions that did not address malnutrition and 44.8% received inappropriate instructions to limit caloric intake.

CONCLUSIONS

A majority of malnourished adult patients receive inappropriate or inadequate nutrition care instructions at the time of discharge. Clinician education and redesign of nutrition care options in the electronic medical record may improve the provision of post-discharge nutrition care instructions.

摘要

背景

营养不良仍然是住院成人中一个重要但未被充分认识的问题。尽管存在旨在改善出院后营养状况的干预措施，但很少有研究探讨出院时给予了多少次以及何种类型的营养护理指导。本研究旨在回顾为营养不良的成年人提供的以营养为重点的出院护理。

方法

我们回顾了营养师在 4 个月期间确定为营养不良的成年患者的电子病历中提供的出院营养护理指导。

结果

在研究期间，确定了 76 名符合条件的患者。超过一半的营养不良病例（64.5%）归因于慢性疾病。根据电子病历记录，6.6%的患者接受了口服营养补充剂的出院指导，30.3%的患者获得了新的或更改的维生素/非热量补充剂处方。近一半的患者（47.4%）接受了一般性饮食指导，这些指导没有针对营养不良，而 44.8%的患者收到了限制热量摄入的不适当指导。