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Addressing Malnutrition in Australian Hospitals: A Scoping Review to Inform Systems Thinking.

Jolie Baird1, Kate Desneves1,2, Brooke Chapman2,3

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Malnutrition affects up to 40% of Australian hospital patients, with current strategies being reactive. A systems thinking approach is needed for proactive, effective prevention and care redesign in hospitals.

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Area of Science:

  • Healthcare Management
  • Public Health Nutrition
  • Systems Science

Background:

  • Malnutrition is prevalent in Australian hospitals, impacting 30-40% of patients.
  • Despite being preventable and treatable, effective management strategies are lacking.

Purpose of the Study:

  • To synthesize literature on malnutrition prevalence in Australian hospitals since 2000.
  • To identify implemented strategies and opportunities for systems redesign using a systems thinking focus.

Main Methods:

  • A comprehensive scoping review of four databases (Web of Science, Medline, CINAHL, Scopus) from January 2000 to October 2025.
  • Included 151 studies from 1055 screened records, focusing on prevalence, assessment, and interventions.

Main Results:

  • Nutrition screening completion averaged 71.7%, with 49.8% of patients at risk.
  • Malnutrition prevalence was 38%, with barriers including workload and poor leadership.
  • Interventions were mostly patient-focused; few addressed system-wide approaches.

Conclusions:

  • Malnutrition remains a significant issue in Australian hospitals.
  • Current reactive strategies are insufficient; a proactive, system-wide prevention approach is necessary.
  • Systems thinking can facilitate sustainable models of care and overcome implementation barriers.