Does multifaceted nutritional education improve malnutrition management?

Emilie Reber; Anna Messmer Ivanova; Patricia Cadisch; Jessica Stirnimann; Martin Perrig; Christine Roten; Zeno Stanga

doi:10.1016/j.nut.2020.110810

Does multifaceted nutritional education improve malnutrition management?

Nutrition. 2020 Oct:78:110810. doi: 10.1016/j.nut.2020.110810. Epub 2020 Apr 21.

Authors

Emilie Reber¹, Anna Messmer Ivanova², Patricia Cadisch², Jessica Stirnimann², Martin Perrig³, Christine Roten³, Zeno Stanga²

Affiliations

¹ Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital, and University of Bern, Switzerland. Electronic address: emilie.reber@insel.ch.
² Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital, and University of Bern, Switzerland.
³ Department of General Internal Medicine, Bern University Hospital, Switzerland.

PMID: 32544848
DOI: 10.1016/j.nut.2020.110810

Abstract

Objectives: Malnutrition is a challenging issue in hospitals, but mostly reversible. However, despite being associated with increased morbidity and mortality risk, malnutrition is hardly recognized and treated. There is a strong need to raise awareness of treating residents to improve patients' nutritional management. This study aimed to investigate the impact of an educational intervention on residents' nutritional knowledge, perception, and prescribed nutritional therapies.

Methods: This prospective intervention study was conducted at the Department of General Internal Medicine of the Bern University Hospital. Nutritional risk was evaluated in consecutive patients admitted to the wards using the Nutritional Risk Screening 2002 and the number of prescribed nutritional therapies were assessed. The educational intervention included an interactive case discussion headed by nutritional medicine consultants. A pocket card with basic nutritional information was handed out. Each resident's nutritional knowledge was checked with a multiple choice test before the intervention, immediately after, and after 2 months.

Results: In total, 609 patients were included (121 preintervention, 161 postintervention phase I, 327 postintervention phase II). Overall prevalence of malnutrition was 35%. The percentage of prescribed nutritional therapies was 36%. There was no significant difference between the phases (46% preintervention, 52% postintervention phase I, 27% postintervention phase II) or between the test results (mean percentage of correct answers 61 ± 15%; 57 ± 12%, and 60 ± 10%).

Conclusions: The multimodal intervention failed to achieve both objectives, as neither residents' knowledge and awareness nor the number of prescribed therapies could be increased. Nutritional risk remains highly prevalent; thus, innovative and more effective teaching strategies are needed to increase knowledge, abilities, and skills to fight malnutrition.

Keywords: Education; Malnutrition; Nutritional management.

MeSH terms

Hospitalization
Humans
Internal Medicine
Malnutrition* / prevention & control
Nutrition Assessment
Nutrition Therapy*
Nutritional Status
Prospective Studies