Clinical nutrition in medical gastroenterology: room for improvement

Undernutrition is a problem in hospitals, with lack of nutritional routines. Recently, guidelines concerning the nutritional care process were developed from ESPEN. This study was conducted to assess the present status of nutritional routines among doctors and nurses in internal medicine (IM) and medical gastroenterology (MG), in comparison with the ESPEN guidelines.

A questionnaire-based investigation among doctors and nurses working in departments of internal medicine and gastroenterology in Scandinavia, based on further analysis of previous data.

Overall, 4512 (1753 doctors, 2759 nurses) answered the questionnaire, of which 1155 were from internal medicine and 193 from gastroenterology. A similar, non-significant, discrepancy in attitudes and nutritional routines was noted in gastroenterologists and internists. Concerning basic nutritional education, 46% in MG and 48% in IM considered it insufficient (not significant). When comparing all doctors with all nurses, 60% and 39% respectively considered their basic nutritional education insufficient (p<0.001). Concerning prescription of parenteral nutrition, 65% of the internists and 92% of the gastroenterologists had sufficient knowledge (p<0.001), while technical skill did not differ (not significant). Lack of interest was more pronounced in the internists than in the gastroenterologists, 42% vs. 32% (p<0.05), and more pronounced in doctors when comparing all doctors with all nurses (47 vs. 36%, p<0.001).

A discrepancy between clinical practice and attitudes towards nutrition is evident in both gastroenterology and internal medicine. Although gastroenterologists are more interested, there is room for improvement in both groups. This is true for doctors as well as nurses, even though nurses seem to be more interested and better trained than doctors.