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Recognising undernutrition in a community hospital: the nursing judgement is insufficient

European Journal of Clinical Nutrition volume 76, pages 1611–1614 (2022)Cite this article

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Abstract

Introduction

Standardised nutritional screening methods improve the rate of recognising older patients with undernutrition, which is strongly encouraged in hospitals and residential settings. Therefore, our study compared the rates of identifying undernutrition before and after introducing the Mini Nutritional Assessment (MNA®) in a community hospital.

Methods

This was a single-centre, retrospective, observational before–after study. Participants were subjects aged 65 years or older, admitted to a community hospital from May 2018 to December 2020. The nursing assessment at admission included the MNA® from January 2020. The prevalence of undernutrition gathered by nursing diagnoses from 2018 to 2019 was compared with data obtained using the MNA® in 2020. Then, a confirmatory analysis was conducted to compare the prevalence of undernutrition in 2020 when both nursing diagnoses and the MNA® were used.

Results

We analysed data of approximately 316 patients (238 before and 78 after introducing the MNA®). Overall, results showed that 47.1% (n = 149) of the patients were undernourished. As observed, the prevalence of undernutrition was 38.6% (n = 92) in 2018–2019 and 73.1% (n = 57) in 2020 (p < 0.001). In 2020, however, 38.5% of patients (n = 30) were identified as undernourished using the MNA® but not using nursing diagnoses. Therefore, the correlation between these two methods was poor (Pearson’s correlation 0.169, p = 0.14).

Conclusion

Identifying elderly patients with undernutrition significantly increased after introducing the MNA®. Undernutrition is a common condition that should be systematically screened using a validated tool to activate personalised nutritional interventions promptly.

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Fig. 1: Comparison between the undernutrition frequencies observed was estimated using the MNA® and nursing diagnoses for patients admitted in 2020.

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Data availability

The data that support the findings of this study are available from the corresponding author, BG, upon reasonable request.

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Acknowledgements

We thank the nursing staff of the community hospital of Loreto (Ancona). This research received no specific grant from any funding agency, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Section of Hygiene and Public Health, Università Politecnica delle Marche, Via Tronto 10, 60126, Ancona, Italy

    Beatrice Gasperini, Ilenia Carletta, Donatella Sarti & Emilia Prospero

  2. Geriatrics, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Viale Vittorio Veneto, 2, 61032, Fano, PU, Italy

    Beatrice Gasperini & Emma Espinosa

  3. School of Nursing, Università Politecnica delle Marche, Via Tronto 10, 60126, Ancona, Italy

    Gilda Pelusi

  4. Intermediate care-Community Hospital, Area Vasta 2, Via San Francesco D’Assisi 1, Loreto, AN, 60025, Italy

    Annamaria Frascati

  5. ASUR Marche, Ancona, Viale Colombo 106, Ancona, 60127, Italy

    Franco Dolcini

Authors
  1. Beatrice Gasperini
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  2. Gilda Pelusi
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  3. Annamaria Frascati
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  4. Ilenia Carletta
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  5. Franco Dolcini
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  6. Donatella Sarti
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  7. Emma Espinosa
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  8. Emilia Prospero
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Contributions

BG: Study concept and design, analysis, and interpretation of data, writing the report, conducting the search. GP: Study concept and design, formulating the research question, interpretation of data. AF: Acquisition of data, interpretation of data, writing the report. IC: Acquisition of data, interpretation of data, writing the report. FD: Acquisition of data, interpretation of data. DS: Analysis and interpretation of data, writing the report, extracting, and analysing data, interpreting results, and creating tables and figures. EE: Drafting of the manuscript, critical revision of the manuscript for important intellectual content and provided feedback on the report. EP: Conceived and designed the experiments, analysis and interpretation of data, critical revision of the manuscript for important intellectual content and provided feedback on the report.

Corresponding author

Correspondence to Beatrice Gasperini.

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Competing interests

The authors declare no competing interests.

Ethical approval

Given this was a retrospective observational study, ethical committee approval was not required. The study was performed in accordance with the Code of Ethics of the World Medical Association for experiments involving humans (Declaration of Helsinki) and research on health databases (Declaration of Taipei). Patients and caregivers gave their consent to use their personal data at their admission to the CH. Patient anonymity was respected during the process of data analysis and results reporting.

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Gasperini, B., Pelusi, G., Frascati, A. et al. Recognising undernutrition in a community hospital: the nursing judgement is insufficient. Eur J Clin Nutr 76, 1611–1614 (2022). https://doi.org/10.1038/s41430-022-01145-y

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