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A small team of dedicated, Clinical Nutrition staff at UHN is making strides in preventing and treating malnutrition in patients – an issue that affects about 45 per cent of adults admitted to hospital, according to the Canadian Malnutrition Task Force (CMTF).
"Malnutrition often goes under-recognized in patients, resulting in many not receiving timely intervention when they need it," says Kathy Cohen, Registered Dietitian at the Stroke Prevention Clinic at Toronto Western Hospital (TW).
Malnutrition is a deficiency in energy, protein and other nutrients which affects an individual's functional ability, body tissues and overall health. Some of the key factors that increase the risk of malnutrition for patients with stroke, both in hospital and in the community, are fatigue, cognitive deficits, difficulty swallowing and depression.
Earlier this year, Kathy and her U of T Masters of Public Health student, Jamie Yermus, piloted a new Malnutrition Screening Tool (MST) for patients in the clinic.
Patients were asked if they had recently lost weight without trying, and if they have been eating poorly due to a decreased appetite. Their responses were then placed on a scale to determine the patient's risk of malnutrition. Almost one in four patients screened were found to be at risk.
With the support of the clinic team, this tool is now in place. Kathy routinely screens patients and provides nutrition education and counselling for those at risk of malnutrition.
"The results have been very positive – patients have expressed having more energy, eating better, gaining weight or able to maintain their weight, and feeling better equipped to make changes to their nutrition," Kathy says.
Why is malnutrition screening important?
Patients who are malnourished are more likely to be readmitted to hospital, recover slower and be at risk for higher mortality, according to the CMTF.
Malnutrition is often complicated by acute conditions, such as trauma, infections and diseases that cause inflammation.
The Malnutrition Awareness Committee at UHN, a multi-disciplinary team, emphasizes the importance of nutrition screening for patients in hospital.
Dr. Johane Allard, Director of the Nutrition Support Program at UHN and co-chair of the Canadian Malnutrition Task Force, recommends that nutrition care processes should involve a team of physicians, nurses, registered dietitians, diet technicians and allied health professionals to treat food as medicine.
Canadian Malnutrition Week
Sept. 24-28 is the fourth annual Canadian Malnutrition Week, spearheaded by the Canadian Malnutrition Task Force.
"It's a great opportunity to increase awareness of the role nutrition has on patients' health and recovery," Kathy says.
"Educating healthcare professionals about the importance of early detection and treatment is essential for optimal patient care."