NSW
Nutrition Screening Week 3 down 1 to go
CHRISTINE RUSSELL Chair NSW
BAPEN’s Nutrition Screening Week 2011
NSW11 NSW11
BAPEN’s Nutrition Screening Week 2011
On behalf of the Nutrition Screening Week (NSW) project team I should like to thank all centres who participated in the 2010 survey and to apologise for the delay in printing the report and sending out the local results. Unfortunately we encountered a number of problems with data entry and analysis but I am pleased to say that the report is now published and available to view on the BAPEN website and feedback has been sent to all participants.
NSW11 BAPEN’s Nutrition Screening Week 2011
NSW10 was the third nutrition screening survey undertaken in UK but for the first time it was extended to include hospitals and care homes in the Republic of Ireland (ROI). The survey was carried out from 12-14th January 2010, reflecting the prevalence of ‘malnutrition’ in the winter.
UK Survey- Key findings Hospitals:
185 hospitals participated providing data on 9668 patients admitted during the 3 days of the survey. The overall prevalence of ‘malnutrition’ (medium + high risk according to ‘MUST’) was 34% (21% high risk, 14% medium risk) which was higher than that found in the previous surveys when the prevalence was 28%. The reason for this increase is not clear and may be due to a number of factors. The patient population in the 2010 survey was significantly older than that of the 2008 and 2007 surveys; more women were included who were older and more at risk than men. Furthermore, whilst there were a similar proportion of patients admitted with cancer or with respiratory disease in all surveys, the prevalence of ‘malnutrition’ associated with these conditions was higher in 2010 than in 2008 (44% v 40% and 42% v 37% respectively). There was a significant difference in ‘malnutrition’ risk between the 4 countries of the UK; Scotland 27%, Wales 33%, England 35%, Northern Ireland 38%, though three quarters of all the patients in the survey were admitted to hospitals in England.
Care homes:
148 care homes took part providing data on 857 residents admitted during the previous 6 months. The overall prevalence of ‘malnutrition’ was 37% (23% high risk, 15% medium risk) which was lower than in the 2008 survey (42%) but higher than in the 2007 survey (30%). This variation may be due to differences in the mix of care homes taking part each year. As in previous surveys the prevalence was greater in exclusively nursing homes than exclusively residential homes (45% v 30%) and in residents admitted from other care settings. There was no significant difference in ‘malnutrition’ risk between the countries of the UK.
Almost 60% residents had neurological conditions with an associated prevalence of ‘malnutrition’ of 41%. About a third of the
5 BAPEN In Touch No.60 February 2011 residents were thin with a BMI of <20kg/m2 and
a low BMI contributed to 8 out of 10 residents categorised as ‘malnourished’.
Mental Health Units:
20 mental health units submitted data on 146 subjects, 18% of whom were malnourished (12% high risk, 7% medium risk), which was very similar to the findings in previous years. There was a significant difference in prevalence between acute units and long stay / rehab units (29% v 13%). The mean BMI of subjects was higher than that in hospitals and care homes (27 v 26 v 23kg/m2
). As in hopitals, obesity was more
common than underweight. Compared with the 2008 survey, there was a noticeable increase in the proportion of units that included nutritional information on ‘malnourished’ patients in discharge letters.
Some new questions were included in the
2010 survey relating to standards for weighing scales used in healthcare settings, nutritional screening tools used and training on screening provided. In all care settings there was a lack of awareness of standards re weighing scales though most respondents who said they were aware knew that scales should be regularly calibrated. ‘MUST’ was the most commonly used screening tool in all settings and lectures/workshops the most usual approach to training. However, e-learning is increasingly being used in healthcare and the BAPEN e-learning module on Nutritional Screening using ‘MUST’ is a cost effective way of providing training.
ROI Survey- Key findings Hospitals:
29 hospitals took part in the survey providing data on 1602 patients. The overall prevalence of ‘malnutrition’ on admission was 33% (25% high risk, 8% medium risk) - similar to that of the UK. Slightly fewer women were included than men and unlike the UK there was no difference in the prevalence of ‘malnutrition’ between sexes despite women being significantly older than men. The
mean BMI was 27kg/m2 , only 8% were
underweight and 27% were obese. A low BMI contributed to 28% of patients categorised as ‘malnourished’ compared to 46% in the UK survey. 6 out of 10 hospitals were aware of standards relating to weighing scales stating that scales should be calibrated regularly. Over half the hospitals used a screening tool and of these 81% used ‘MUST’. As in the UK, lectures/workshops were the usual form of training on nutritional screening.
Care homes:
17 care homes provided data on 154 residents, 32% of whom were at risk of ‘malnutrition’ (16% high risk, 16% medium risk). Three quarters of residents were in exclusively nursing homes where the risk was higher than in exclusively residential homes (34% v 9%). Just over half residents were admitted from their own homes and a third from hospitals. The risk of ‘malnutrition’ in those admitted from their own homes was higher than in those from hospitals (30% v 21%). The mean BMI was 24.3kg/m2
and
underweight was twice as common as obesity. A low BMI contributed to 7 out of 10 ‘malnourished’ residents. All care homes used a screening tool, ‘MUST’ being used in 53% and the Mini Nutritional Assessment tool (MNA) being used in the remainder. These care homes were the only locations in the survey (ROI and UK) where this tool was being used.
The results from the survey have provided some useful insights into the practice and policy for nutritional screening and prevalence of ‘malnutrition’ in hospitals and care homes in Ireland. However, factors affecting admission to care in countries with different healthcare systems vary and these should be borne in mind when comparing the results of Ireland and the UK. The fourth and final Nutrition Screening
Week Survey is to be held from 6-8th April this year. We hope that as many centres as possible will take part to help us complete this series of surveys after which the data from them all will be amalgamated to provide a more complete picture of ‘malnutrition’ across the UK and the Republic of Ireland.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16