Department of Gastroenterology and Hepatology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore.
Department of General Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore 544886, Singapore.
Nutrients. 2023 Oct 24;15(21):4492. doi: 10.3390/nu15214492.
The nutritional status of hospitalised patients is often at risk or compromised and predisposed to further deterioration after discharge, leading to poor clinical outcomes, high healthcare costs, and poor quality of life. This paper aims to provide evidence-based best-practice recommendations to address this, supported by a national survey of healthcare professionals in Singapore and reviewed by a multidisciplinary expert panel under the Sarcopenia Interest Group of Society of Parenteral and Enteral Nutrition Singapore (SingSPEN). We advocate screening all patients with a validated tool which includes a disease activity/burden component, an easily accessible dietitian referral pathway for patients at risk of malnutrition, and an individualised nutrition care plan formulated and delivered using a multidisciplinary team approach for patients at risk or with malnutrition. A comprehensive team would include not only dietitians but also physicians, nurses, physiotherapists, speech therapists, and medical social workers working together towards a common goal. Information on why nutrition is important for good health and how it can be achieved should also be provided to all patients and their caregivers before and after hospital discharge. With the above recommendations, we seek to improve upon the current nutrition care processes at discharge for healthcare institutions in Singapore.
住院患者的营养状况常常面临风险或受损,并在出院后进一步恶化,导致临床结局不佳、医疗保健费用高和生活质量差。本文旨在提供循证最佳实践建议,以解决这一问题,该建议得到了新加坡医疗保健专业人员的全国性调查的支持,并由新加坡肠外和肠内营养学会(SingSPEN)肌肉减少症兴趣小组下的多学科专家小组进行了审查。我们提倡使用经过验证的工具对所有患者进行筛查,该工具包括疾病活动/负担组成部分,为有营养不良风险的患者提供易于获得的营养师转介途径,以及为有营养不良风险或营养不良的患者制定和实施个体化的营养护理计划,采用多学科团队方法。一个全面的团队不仅包括营养师,还包括医生、护士、物理治疗师、言语治疗师和医务社会工作者,共同朝着一个共同的目标努力。在出院前和出院后,还应向所有患者及其护理人员提供有关营养对健康重要性以及如何实现营养的信息。通过以上建议,我们旨在改善新加坡医疗机构目前的出院时营养护理流程。