title: [Quality of care in nursing homes: a review of literature regarding structure, process and outcome indicators related to the risk of malnutrition].
abstract: BACKGROUND
  The admissions and the demands for entering nursing homes (NHs) are gradually increasing. Focusing on the quality of care in NHs, the risk of protein- calorie malnutrition has a key role. The purpose of this paper is to select and describe structure, process of care and outcome indicators, as well as individual risk factors (confounders), related to malnutrition in NHs.
  
  
  METHODS
  We have analyzed scientific articles found in MEDLINE, published from 2000 to 2011, identified through four different string selections.
  
  
  RESULTS
  505 articles have been collected, 17 of whom were chosen because they included specific malnutrition indicators in the framework of quality of care indicators. Three papers specifically deal with malnutrition as one of the elements of the quality of care in NHs linked to structure, processes and outcome.
  
  
  CONCLUSIONS
  From this review, it clearly emerges that scientific articles addressing malnutrition as one of the requirements of healthcare quality in NHs are scarce, compared with a rather large number of publications concerning the prevalence and/or the description of interventions related to--and made to solve or reduce--malnutrition already in place. It is therefore necessary to spread the culture and the approach of nutritional risk analysis within the systems aimed at evaluating the quality of care in NHs, by selecting and monitoring appropriate malnutrition indicators.
authors.affiliation: Dipartimento di Sanità Pubblica, Università degli Studi di Firenze. chiara.lorini@unifi.it
authors.forename: C
authors.initials: C
authors.lastname: Lorini
authors.forename: M
authors.initials: M
authors.lastname: Mencacci
authors.forename: G
authors.initials: G
authors.lastname: Bonaccorsi
mesh_terms: D006801:Humans; D044342:Malnutrition / Q000453:epidemiology*; D009735:Nursing Homes / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care; D019984:Quality Indicators, Health Care; D012307:Risk Factors