Malnutrition in hospital: detection and consequences

Malnutrition in hospital is not a new concept. Studies carried out over 20 years ago identified that 50% of surgical patients (Hill et al, 1977) and 44% of medical patients (Bistrian et al, 1976) showed evidence of malnutrition. A more recent study demonstrated that the problem still exists (McWhirter and Pennington, 1994). This research showed that 40% of patients were undernourished on admission to hospital and 78% of these suffered further deterioration in their nutritional status during their hospital stay. This article, the first in the series, aims to identify patient groups which are likely to become malnourished during hospitalization and outlines how nurses and doctors can detect malnutrition and/or potential malnutrition in patients. The consequences of malnutrition and the current issues surrounding the reported problems of patients who do not receive enough food and drink while in hospital (Association of Community Health Councils, 1997) are discussed. The article also explores what measures can be taken to improve patients nutritional intake while in hospital. It describes the way forward in terms of clinical practice, current projects and the information and training available to nurses and other members of the multidisciplinary team. The author's overall aim is to improve healthcare professionals' knowledge within this field and to raise the profile of nutritional care.