Sharn Amy R, Phillips Wendy, Stutts John T, Kaminski Mary, Shepps Amy, Arensberg Mary Beth
Global Medical Affairs and Research, Abbott Nutrition Division of Abbott, 2900 Easton Square Place, Columbus, OH 43219, USA.
Morrison Healthcare, 7900 Victoria Circle, Independence, OH 44131, USA.
Children (Basel). 2024 Nov 26;11(12):1434. doi: 10.3390/children11121434.
Nutrition is fundamental to a child's growth and development. However, nutritional health is often compromised by acute and chronic conditions and treatments that can commonly result in malnutrition. Malnutrition encompasses undernutrition and overnutrition and may be exacerbated by food insecurity. Recent health policy efforts in the United States (US) include those focused on quality measurement and social determinants of health (SDOH) to reduce risks for malnutrition and food insecurity. Nutrition-focused quality improvement programs (QIPs) have emerged as a successful model for benchmarking current nutrition care in adult patients and creating pathways for establishing best practices for timely malnutrition screening, intervention, and appropriate follow-up and care coordination. However, less is known about opportunities for nutrition-focused QIPs in hospital pediatric malnutrition care. This helps fill the gap by discussing the problem of pediatric malnutrition and current US quality frameworks and child nutrition programs related to malnutrition and food insecurity. In addition, this summarizes how nutrition-focused QIPs can impact malnutrition, including how QIPs can link hospital care with patient discharge planning and outpatient interventions. Finally, the outlines specific opportunities for the implementation of pediatric nutrition-focused QIPs to reduce office visits and/or inpatient readmissions through appropriate nutrition screening, assessment, and interventions.
营养是儿童生长发育的基础。然而,营养健康常常受到急性和慢性疾病以及治疗的影响,这些情况通常会导致营养不良。营养不良包括营养不足和营养过剩,并且可能因粮食不安全状况而加剧。美国近期的卫生政策举措包括那些侧重于质量衡量和健康的社会决定因素(SDOH)以降低营养不良和粮食不安全风险的举措。以营养为重点的质量改进项目(QIPs)已成为一种成功模式,用于衡量成年患者当前的营养护理情况,并为建立及时进行营养不良筛查、干预以及适当的后续跟进和护理协调的最佳实践创造途径。然而,对于以营养为重点的QIPs在医院儿科营养不良护理中的机会了解较少。本文通过讨论儿科营养不良问题以及当前美国与营养不良和粮食不安全相关的质量框架及儿童营养项目来填补这一空白。此外,本文总结了以营养为重点的QIPs如何能够影响营养不良,包括QIPs如何将医院护理与患者出院计划及门诊干预相联系。最后,本文概述了实施以儿科营养为重点的QIPs的具体机会,以便通过适当的营养筛查、评估和干预来减少门诊就诊和/或住院再入院情况。