Relationship between Intake and Rate of Readmission Essay Example

have two or more of six characteristics: insufficient energy intake, weight loss, physical findings like muscle mass or subcutaneous fat loss, fluid accumulation, or reduced hand grip strength.

Refer to appendix A for the explicit criteria of diagnosing malnutrition (White et al., 2012). This literature review encompasses studies that investigate effective interventions on patient dietary intake and potential supplementations.

Nutrition Intervention Studies

A randomized, double-blind, placebo-controlled study was conducted by Deutz, Matheson, Matarese, Luo, Baggs, Nelson, & Zeigler (2016) on malnourished patients who were over 65 years old. The Subjective Global Assessment (SGA) screening tool was used in this study. The focus was directed towards this specific population due to their heightened vulnerability to factors associated with malnutrition such as increased morbidity and mortality rates as well as a greater likelihood of hospital readmissions. Patients were assigned randomly to receive either high-protein beta-hydroxy-betamethybutyrate (HP_HMB) or a placebo.

According to Deutz (2016), HP-HMB is a high protein supplement that has been monitored for its effects on readmission rates and mortality. However, no changes were observed in these data when using the HP-HMB supplement alone. Conversely, when the HP-HMB supplement was administered early along with current nutritional care, there was a decrease in patient death rates after discharge and an improvement in nutritional status.

Baldwin et al. (2016) conducted a study to evaluate the effectiveness of various approaches to increase dietary intake in malnourished or nutritionally at-risk adults. This intervention review examined several supportive interventions across multiple studies, including changes to nutritional care organization, alterations to the feeding environment, modification of meal profiles or patterns, additional meal supplementation, and implementation of home meal delivery systems.

Fifteen reviewed research articles have found that supportive

interventions can result in an average weight increase of .6 kg for patients compared to others. Additionally, 41 randomized controlled studies have indicated the potential of supportive interventions in increasing dietary intake and reducing mortality, but further comprehensive research is still required for confirmation (Baldwin et al., 2016). Kondrup (2001) conducted a ten-year study at a hospital in Denmark, exploring the relationship between components of the food cycle in the hospital and the ability to enhance patient food intake prior to discharge. Various protocols were implemented throughout the study to improve patient intake.

The results showed that by improving various aspects of the food chain, significant patient weight loss can be prevented in 90% of patients. One major improvement involved considering all aspects of the food chain, such as culinary skills, recipes, patient nutritional screening, monitoring, menu planning, preparation, distribution, serving, ambience of food presentation and delivery, patient information,and motivation (Kondrup 2001). This study emphasized the importance of further development in screening patients,moving planning and preparation,and training to improve dietary intakes. In another study conducted by Sharma et al. (2017), a randomized trial with 148 patients was carried out to investigate the benefits of early extended nutrition intervention along with usual care and a three-month follow-up for older hospitalized patients. The study included 70 patients in the control group and 78 patients in the intervention group.

The SGA screening tool results did not show any significant changes before and after intervention regarding complication rate during hospitalization or mortality. However, in the intervention group, the median total length of stays was reduced by six days. For this specific population, it is recommended to provide early and extended

nutrition intervention to decrease length of stays and improve nutritional status.

Conclusion

The malnutrition initiative at MIH has proven beneficial for a patient's continuity of care after discharge by informing their primary physician and including a discharge sheet in EPIC that identifies the recommendation for oral supplementation post-discharge. This research project aimed to determine the relationship between adequate oral intake and the rate of readmission, suggesting potential interventions prior to a patient's discharge from the hospital.