title: The prevalence of malnutrition in hospitals can be reduced: results from three consecutive cross-sectional studies.
abstract: OBJECTIVE
  To assess and compare the rates of malnutrition in Hammersmith Hospital NHS Trust over a 5-year period following changes in hospital nutrition care strategies.
  
  
  METHODS
  
  
  
  METHODS
  Three consecutive cross-sectional studies carried out in 1998, 2000 and 2003.
  
  
  METHODS
  Inpatients at Hammersmith Hospital NHS Trust.
  
  
  METHODS
  A total of 2283 inpatients aged over 16 years old, 686 in 1998, 780 in 2000, 817 in 2003. Inpatients excluded: ventilated patients, ante/post-natal women and people aged <16.
  
  
  METHODS
  Improvements in the catering service and nutrition education provision in 2000, and the implementation of a nutrition screening tool and 'Better Hospital Food' in 2003.
  
  
  METHODS
  Prevalence of malnutrition.
  
  
  RESULTS
  There was a reduction in the prevalence of malnutrition in 2000 and 2003 from baseline data in 1998 (1998: 23.5%, 161/686; 2000: 20.4%, 159/780; 2003: 19.1%, 156/817; P<0.001). The odds ratio of being either at risk of malnutrition or malnourished was reduced in both 2000 and 2003 by approximately 33% (P=0.001). Indicators of good nutritional practice also improved: Weighing patients on admission increased from 37.5% (257/686) in 1998, to 42.9% (335/780) in 2000, and 59.6% (487/817) in 2003 (P0.001). Dietetic referrals also increased from 31.5% (216/686) in 1998 to 41.6% (340/817) in 2003 (P<0.001)(no change in 2000, 31%, 242/780). Appropriate referrals also improved, results showing that the proportion of malnourished patients who were referred showed a dramatic increase in 2003 (1998: 91/161, 56.5%; 2000: 85/159, 53.5%; 2003: 111/156, 71.2%; P=0.003).
  
  
  CONCLUSIONS
  The prevalence of malnutrition in hospital can be influenced by the implementation of a variety of nutrition care strategies, which target identification of malnutrition and its treatment.
authors.affiliation: Department of Nutrition and Dietetics, Hammersmith Hospital NHS Trust, Fulham Palace Road, London W6 8RF UK.
authors.forename: Jacqui
authors.initials: J
authors.lastname: O'Flynn
authors.forename: Hilary
authors.initials: H
authors.lastname: Peake
authors.forename: Mary
authors.initials: M
authors.lastname: Hickson
authors.forename: David
authors.initials: D
authors.lastname: Foster
authors.forename: Gary
authors.initials: G
authors.lastname: Frost
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D004046:Dietetics / Q000379:methods / Q000592:standards*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology* / Q000628:therapy*; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D016017:Odds Ratio; D015995:Prevalence; D011787:Quality of Health Care; D012307:Risk Factors