Length of hospital stays can be shortened – with new standard for inpatient nutrition

Nutrition screening and treatments will help hospitalised Covid-19 patients

Reducing inpatient malnutrition estimated to save 30,000 bed days and €24m per year

30,000 bed days and €24m can be saved across Irish public hospitals per year – if all sites implement a new national standard for inpatient nutrition.

It is also forecast that length of patient stays will be shortened – and the recovery of hospitalised Covid-19 patients can be improved.

These benefits were highlighted by IrSPEN, the Irish Society for Clinical Nutrition and Metabolism at a large briefing and guidance event it hosted, on the new mandatory National Clinical Guideline 22 on inpatient nutrition in public hospitals.

Nutrition screening and use of oral nutrition support for adults in the acute care setting is the first time a mandated guideline has been published on nutrition in public hospitals and the key elements are:

  • All patients must be screened by nurses for nutritional status on admission to a public hospital
  • Identified patients to be given supplementary oral nutrition support
  • High risk patients to be referred for nutrition assessment by a Dietitian
  • All inpatients to be rescreened every week.

The protocol was developed through the National Clinical Effectiveness Committee (NCEC), and published by the Department of Health.

Public hospitals were today encouraged to establish working groups to implement the screening and treatments.

IrSPEN President and Consultant Surgeon Professor John Reynolds said 30% of people who come into hospital have malnutrition problems which greatly affect their outcomes.

“Those who typically present as malnourished include people who live with serious diseases, who have difficulty swallowing, people with dementia and frail older people. These patients stay on average 30% longer in hospital and have up to three times the rate of complications.

“Many patients are too sick and unwell to have a normal appetite, and for those patients, we need to act sooner to provide supplementation, together with an enriched hospital menu including higher energy and protein content.”

IrSPEN Director Niamh Rice said full public hospital implementation of the Guideline would bring significant benefits for both vulnerable patients and the future management of health resources.

“Ensuring that vulnerable patients become identified and properly nourished while in hospital, will aid their recovery and reduce other infections, complications, or poor wound healing. A Budget Impact Analysis shows that improved patient nutrition can help to release 31,750 bed days across public hospitals and annual net savings of €24million.”

Clinical Specialist Dietitian at Beaumont Hospital Carmel O’Hanlon added that the approach is also beneficial for Covid-19 patients.

“Patients admitted with Covid-19, are likely to have been unwell for up to ten days while at home and have had significant loss of appetite. Most post-ICU Covid-19 patients will also have difficulty getting back to full diet and need oral nutrition supplements (ONS).

See also www.irspen.ie

Notes to Editors

  • Nutrition screening and use of oral nutrition support for adults in the acute care setting can be viewed at https://www.gov.ie/en/collection/c9fa9a-national-clinical-guidelines/ (guideline 22).
  • The Guideline does not cover private hospitals, in the home, in nursing homes, or other care facilities.
  • It has been estimated that the overall annual healthcare cost of malnutrition in Ireland is €1.42bn (2012), or more than 10% of the total annual healthcare budget. This figure is based on the population as a whole and including hospital and community settings both public and private.
  • The effects of malnutrition on patients include: impaired immune response, reduced muscle strength and fatigue, inactivity, impaired body temperature regulation, impaired wound healing, impaired regulation of salt and fluid and impaired psycho-social function.

Further Information

Ronan Cavanagh, Cavanagh Communications: (086) 317 9731