Improving nutritional screening of patients aged over 75 years admitted to internal medicine wards: a best practice implementation project.

IF 2 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Marta Arnaldos-Esteban, Delia González-de la Cuesta, Mamen Ostáriz-Cárcamo, Marta Carmona-Mozota, Isabel Antolín-Asensio, Beatriz Molinero-González-de la Cuesta, Carmen Rebollo-Pina, Laura Albornos-Muñoz
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Abstract

Introduction: Malnutrition, resulting from insufficient nutritional intake or poor dietary choices, significantly affects hospitalized patients, leading to longer hospital stays and increased health care costs. The European Nutrition for Health Alliance and subsequent initiatives have emphasized the importance of nutritional screening.

Objectives: This study aimed to improve nutritional screening among patients aged over 75 years admitted to internal medicine wards by assessing compliance with best practices and identifying and addressing barriers to effective implementation of recommended practices.

Methods: Using the JBI Evidence Implementation Framework, the project involved a structured audit and feedback process across seven phases. Baseline audit data were collected from all patients aged over 75 years admitted to internal medicine wards over 1 month. The JBI Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) audit and feedback tools were used to identify barriers and develop strategies to address them. A follow-up audit was conducted 6 months post-implementation to measure changes in compliance with recommended practices.

Results: The follow-up audit showed a significant improvement in compliance with best practices, which increased from 22.62% at baseline to 48.26%, reflecting the effectiveness of the targeted interventions. Nurses reported enhanced knowledge and confidence in conducting screenings, although gaps in documentation practices remained.

Conclusion: This project successfully improved compliance with nutritional screening practices, highlighting the importance of stakeholder engagement, training, and support. Future efforts should focus on sustaining these improvements through enhanced training and interdisciplinary collaboration, with the aim of improving the outcomes of patients at risk of malnutrition.

Spanish abstract: http://links.lww.com/IJEBH/A521.

改进75岁以上住院内科病房患者的营养筛查:最佳实践实施项目。
导读:营养不良是由于营养摄入不足或饮食选择不当造成的,严重影响住院患者,导致住院时间延长和医疗费用增加。欧洲营养促进健康联盟及其后续倡议强调了营养筛查的重要性。目的:本研究旨在通过评估最佳实践的依从性,识别和解决有效实施推荐实践的障碍,改善75岁以上住院内科病房患者的营养筛查。方法:使用JBI证据实施框架,该项目涉及七个阶段的结构化审计和反馈过程。基线审计数据收集自所有75岁以上住院内科病房超过1个月的患者。使用JBI临床证据系统的实际应用(PACES)和将研究付诸实践(GRiP)审计和反馈工具来识别障碍并制定解决这些障碍的策略。实施后6个月进行了跟踪审计,以衡量遵守建议做法的变化。结果:随访审计显示,最佳实践的符合性显著提高,从基线时的22.62%提高到48.26%,反映了针对性干预的有效性。护士报告说,在进行筛查方面的知识和信心有所提高,尽管在记录实践方面仍然存在差距。结论:该项目成功地提高了对营养筛查实践的遵从性,突出了利益相关者参与、培训和支持的重要性。未来的努力应侧重于通过加强培训和跨学科合作来维持这些改善,目的是改善有营养不良风险的患者的预后。西班牙文摘要:http://links.lww.com/IJEBH/A521。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
13.00%
发文量
23
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