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Nutritional care; do process and structure indicators influence malnutrition prevalence over time?

Judith M M Meijers¹, Frans Tan², Jos M G A Schols³

¹Department of Health Services Research, CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.

Clinical Nutrition (Edinburgh, Scotland)

|July 30, 2013

Summary

Malnutrition prevalence in long-term care decreased significantly from 2007-2011. Enhanced nutritional screening, not structural policies, was key to reducing malnutrition rates over time.

Keywords:

Malnutrition Outcome Prevalence Process Structure Trend

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Area of Science:

Gerontology
Public Health
Nutrition Science

Background:

Malnutrition is a significant issue in long-term care, yet factors influencing its prevalence over time remain unclear.
Understanding the impact of nutritional care processes and structural elements is crucial for improving resident outcomes.

Purpose of the Study:

To analyze trends in malnutrition prevalence in Dutch long-term care facilities from 2007 to 2011.
To investigate the influence of structural and process indicators of nutritional care on these trends.

Main Methods:

Longitudinal data from the Dutch National Prevalence Measurement of Care Problems (LPZ) (2007-2011) were analyzed.
Mixed-linear regression models assessed the impact of nutritional screening, oral nutritional supplementation (ONS), and structural indicators on malnutrition prevalence.
Malnutrition was determined by BMI, unintended weight loss, and nutritional intake.

Main Results:

Malnutrition prevalence significantly decreased from 26% to 18% between 2007 and 2011 (P < 0.001).
Increased nutritional screening was associated with lower malnutrition prevalence over time.
Higher use of oral nutritional supplementation (ONS) correlated with higher malnutrition prevalence.
Structural indicators (guidelines, protocols) did not significantly impact malnutrition prevalence trends.

Conclusions:

A higher degree of nutritional screening is linked to a reduced prevalence of malnutrition in long-term care settings.
While ONS use is associated with higher malnutrition, it may reflect its use in treating existing malnutrition.
Implementing robust structural nutritional screening is a vital intervention for managing malnutrition long-term.