Preadmission nutrition screening: expanding hospital-based nutrition services by implementing earlier nutrition intervention.
The need to screen patients earlier than within the first 24 hours of hospital admission has resulted in the development of preadmission nutrition screening. At Providence Saint Joseph Medical Center (PSJMC), a 455-bed acute-care facility, this procedure has been used since 1994. The preadmission screening method was developed because of the use of critical pathways for patients in specific diagnosis-related groups. Critical pathways specified that registered dietitians must assess these patients within 24 hours of admission at PSJMC. However, at that time there was minimal data in the chart from which to assess the patient's nutritional status and the ability to interview the patient was often limited as a result of intubation or postoperative pain. Family members were not always available at the hospital to discuss a patient's preadmission nutritional status. To address this problem, we developed a system to call people at home before their admission to the hospital to obtain specific nutrition information. To analyze the effectiveness of the procedure, the Food and Nutrition Services Department developed a process to assess this method of screening and to improve the system. Patients were enrolled in a study over a 1-month period, demographics were identified for this sample population, and patient satisfaction was determined via an interview conducted by a dietetic technician after the patient was admitted. Most patients found this to be a very helpful process and an example is presented here on the role of preadmission nutrition screening in improving patient outcome. To better define the population of the case study presented, additional information was gathered on a second study group of patients screened before admission who were admitted for hip and knee surgery, one of the specific diagnosis-related groups with a critical pathway. Our findings indicate that preadmission nutrition screening has the potential to improve patient outcomes by increasing nutrient intake before their hospital admission, reducing hospitalization length, and enhancing patient satisfaction during their hospital stay.
Schwartz
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Food and Nutrition Service, Providence St Joseph Medical Center, Burbank, CA 91505, USA.
Gudzin
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001827:Body Height; D001835:Body Weight; D004045:Dietary Services / Q000379:methods*; D004435:Eating; D005260:Female; D005521:Food Service, Hospital; D006615:Hip / Q000601:surgery; D006745:Hospital Bed Capacity, 300 to 499; D006801:Humans; D007717:Knee / Q000601:surgery; D015596:Nutrition Assessment; D017060:Patient Satisfaction; D012709:Serum Albumin / Q000032:analysis; D015431:Weight Loss
D012709:Serum Albumin