NutritionDay
NutritionDay worldwide is the biggest and most global study on the nutritional situation in hospitals and nursing homes with the aim to increase awareness of malnutrition in patients and old people.
Background
In 1977, malnutrition was found already in surgical patients.
However, malnutrition is in Public Health a still underestimated problem with economically relevant effects dar.
A study conducted in the UK in 2005 study has estimated the costs incurred by malnutrition to a sum of around 10.6 billion euros, which is double of those costs incurred by obesity ( € 5.1 billion ).
Because of your age and health condition especially hospitalized patients and nursing home residents have to be concerned at increased risk of malnutrition. Disease-related malnutrition takes significant impact on the length of hospital stay as well as morbidity and mortality rates of hospital patients. Studies have shown that about 31% of hospitalized patients are malnourished or are affected by a risk.
Previous nutritionDay studies have shown that malnutrition is a world still little considered topic in hospitals and nursing homes and leads to higher infection rates, poorer wound healing, frequent cardiac complications and thus longer hospital stays.
Obesity and malnutrition
Worldwide, the focus is in health care to the increasing obesity rates.
The " nutritionDay worldwide " shows that the prevalence of disease-related malnutrition is unacceptably high.
A long time it has been assumed that only patients are malnourished with a low body weight or low body mass index (BMI < 18.5 kg/m2). Studies, however, indicate that the BMI as a reference is not always well suited to determine malnutrition. In patients with high body fat percentage showed that the sensitivity of BMI reduced and therefore this parameter is insufficient as a benchmark.
Malnutrition in hospital
The problem of malnutrition in hospitals treated a resolution of the Council of Europe ( "Resolution ResAP (2003 ) 3 on food and nutritional care in hospitals ").
It was signed by 18 States. The resolutions of the Council of Europe are political declarations of intent. However, they are not mandatory, more than normative influence on practice in the Member States. The solution to this problem begins with the awareness of all parties involved ( treatment provider, patient, family members, hospital administrations, political leaders ) for the relationships between nutrition and recovery. Recognition of the interaction is complicated by the fact (as opposed to drug approvals ) the relationship between nutrition and recovery is not immediately visible.
The nutritionDay worldwide project
The " nutritionDay worldwide " was supported by the Austrian " Society for Clinical Nutrition" (LFS ) together with the " European Society of Clinical Nutrition " ( ESPEN ) under the direction of ao Univ. Prof. Dr. Michael Hiesmayr (Medical University of Vienna ) has been launched to reduce the problem of disease-related malnutrition.
The project " nutritionDay worldwide " approach to create a global map in which the prevalence of malnutrition, the nutrition status of patients as well as the nutrition-relevant health care structures in hospitals and nursing homes can be seen the target. At the same time emphasized in hospitals and nursing homes with the help of the project, the importance of adequate clinical nutrition and awareness to strengthen it.
The nutritionDay took place in January 2006 for the first time in hospitals in the German language area. 2007, the project was extended to the Settings nursing homes and intensive care units and is carried out annually since then in all three settings. 2012 " oncology nutritionDay " was performed as the first disease-related nutritionDay.
The audit asks nutrition related information on our station or patient level. Based on four questionnaires information on the nutritional status of the patients are collected. Worldwide takes place this survey in a defined day of the year.
Of particular interest is the hospital ward as an independent organizational unit. Due to the prevailing suburb specific processes or even the corporate culture in which the survey is conducted, these characteristics take different influence on the result of the survey.
Transnational Approach
Hospitals and nursing homes from 51 countries worldwide have participated on nutritionDay. About 132,000 patient and resident data were able to be collected.
The questionnaires are available in over 30 languages and thus make it possible to take into account can therefore often disadvantaged groups (eg, persons who do not speak the local language ) also.
Progress of the audit
On a date in November, the nutritional status of patients and nursing home residents as well as relevant nutrition-related health care structures are recognized in participating hospital wards and nursing care facilities and thus an actual state levied. After a period of stay of the patient or resident is a " Outcome Evaluation" captured.
Collected data are entered by the staff in a database. Each station receives data input by a station-related earnings report in which its own data juxtaposes those of the same subject. This benchmarking allows a performance comparison and the chance to initiate improvements through repeated participation. Through repeated participation in the project activities can be evaluated and successes are made visible. Participation is voluntary and free of charge.
NutritionDay questionnaires
Based on four to five questionnaires information is collected from the participating hospital wards or nursing homes and their patients or residents. One focus of the survey is on the one hand on the nutritional supply structure, the health of the residents as well as their weight and food intake behavior. The station as a direct care unit of a group of patients with all their specific properties, their professions, their patient population and the local culture on the other hand also of great interest.
The direct survey using a questionnaire is a specific feature of the " nutritionDay " project. Data are collected on the one hand eating habits of the day on which the survey is conducted ("How much of their lunch / dinner you have eaten today? "). Important other hand, are also the reasons why some patients take no food to him.
NutritionDay Oncology
Especially in cancer patients nutritional therapy plays a major role. Studies have shown that cancer patients with a constant weight obtain better forecasts than cancer patients who lose weight. Specifically, fewer side effects were observed in patients with constant weight, patients likely to speak on therapies and report a higher level of activity and of better quality of life.
In addition, the survival rate of patients with a constant body weight higher as compared to those with weight loss.
The importance of nutritional therapy of cancer patients has taken the occasion nutritionDay to choose in the years 2012 and 2013, an oncology focus.
For " nutritionDay oncology " 3 additional questionnaires are completed and recorded nutritional data relevant to patients with cancer.
Won data of the " nutritionDay oncology " are used as the basis for creating the ESPEN Guidelines to facilitate the nutritional healthcare professional optimization of the nutrition therapy for oncology patients.
Objectives of nutritionDay
The aim of the project is to improve knowledge about and awareness of the problem of patient-related malnutrition, to increase the attention for it, and to promote a safe food supply.
- Awareness of the relationship between food intake and recovery. The target groups are both health professionals and patients, their relatives and political and economic decision-makers.
- Gaining knowledge about inadequate food intake in relation to risk factors, the medical specialty, organizational units and countries in hospitals worldwide.
- Relieve human suffering and reducing the costs for the community.
- Initiation of research projects for "Eat despite illness " and optimal use of the possibilities of artificial nutrition.
Benefit for healthcare facilities
- The stations received through their participation in the project, a benchmark of their stations with other similar stations around the world and from individual action can be derived.
- If you participate may be repeated, in terms of quality management, quality improvement and determine effectiveness increases and evaluate measures.
- Participation promotes good nutritional care in your facility and increases the awareness of the subject of nutrition and malnutrition.
- A repeated participation documented across the development of the nutrition situation of your organization over the years and provides an anonymous international comparison within a field of study.
Results from the study nutritionDay
From the project " nutritionDay " is herauszulesen among other things, what effects nutrition on outcome of hospitalized patients and its health status. These and other results of the nutritionDay audits have been published in studies on nutritionDay in the years 2009 and 2010.
The study of Hiesmayr et al. (2009 ) found that less than 50 % of patients treated in European hospitals, as well as participating in nutritionDay patients were less than the amount received to himself. Furthermore, the study showed a correlation between reduced food intake and increased mortality in the outcome after a period of 30 days. For this reason, reduced food intake as a risk factor for increased mortality can be considered.
In 2009, analyzed Valentini et al. Patients in nursing homes who participated for the first time in the project " nutritionDay ". Analysis of the data from the year 2007 showed that the project caused changes in behavior and an awareness of malnutrition is created.
Schindler et al. examined in their study as the risk of malnutrition in European hospitals assessed and managed. Data of nutritionDay survey data from 2007 and 2008 showed that there are strong differences in the assessment and management of malnutrition in countries and departments that often the patient the required energy demand could not reach.