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Preadmission nutrition screening: expanding hospital-based nutrition services by implementing earlier nutrition
1Food and Nutrition Service, Providence St Joseph Medical Center, Burbank, CA 91505, USA.
Insights
Preadmission nutrition screening improves patient outcomes by increasing nutrient intake before hospitalization and enhancing patient satisfaction. This early intervention helps reduce hospital stays and improves the overall patient experience.
Area of Science:
- Clinical Nutrition
- Healthcare Management
- Patient Outcomes
Background:
- The need for early patient assessment led to the development of preadmission nutrition screening.
- Critical pathways mandated registered dietitian assessments within 24 hours of admission.
- Challenges included limited patient data and patient limitations (intubation, pain) for timely assessment.
Observation:
- A system was developed to gather nutrition information via home calls before hospital admission.
- A study assessed the effectiveness of preadmission nutrition screening over one month.
- Patient satisfaction was evaluated through post-admission interviews.
Findings:
- Preadmission nutrition screening significantly improves patient outcomes.
- It increases nutrient intake prior to hospital admission.
- It has the potential to reduce hospitalization length and enhance patient satisfaction.
Implications:
- Preadmission nutrition screening is a valuable tool for proactive healthcare.
- It optimizes patient nutrition status before admission, potentially leading to better recovery.
- This approach enhances the patient experience and hospital efficiency.
Abstract:
The need to screen patients earlier than within the first 24 hours of hospital admission has resulted in the development of preadmission nutrition screening. At Providence Saint Joseph Medical Center (PSJMC), a 455-bed acute-care facility, this procedure has been used since 1994. The preadmission screening method was developed because of the use of critical pathways for patients in specific diagnosis-related groups. Critical pathways specified that registered dietitians must assess these patients within 24 hours of admission at PSJMC. However, at that time there was minimal data in the chart from which to assess the patient's nutritional status and the ability to interview the patient was often limited as a result of intubation or postoperative pain. Family members were not always available at the hospital to discuss a patient's preadmission nutritional status. To address this problem, we developed a system to call people at home before their admission to the hospital to obtain specific nutrition information. To analyze the effectiveness of the procedure, the Food and Nutrition Services Department developed a process to assess this method of screening and to improve the system. Patients were enrolled in a study over a 1-month period, demographics were identified for this sample population, and patient satisfaction was determined via an interview conducted by a dietetic technician after the patient was admitted. Most patients found this to be a very helpful process and an example is presented here on the role of preadmission nutrition screening in improving patient outcome. To better define the population of the case study presented, additional information was gathered on a second study group of patients screened before admission who were admitted for hip and knee surgery, one of the specific diagnosis-related groups with a critical pathway. Our findings indicate that preadmission nutrition screening has the potential to improve patient outcomes by increasing nutrient intake before their hospital admission, reducing hospitalization length, and enhancing patient satisfaction during their hospital stay.