Despite public focus on the rising obesity problem in the United States, malnourishment remains a common but little-known concern for many hospitalized patients. Malnourishment can lead to negative outcomes following surgery, such as higher infection rates, poor wound healing, and up to three times longer lengths of stay.
Deanna Miller, Missouri Baptist clinical nutrition manager, is leading the effort to combat malnutrition. Research by the American Society for Parenteral and Enteral Nutrition (ASPEN) suggest that as many as 1 in 3 surgical patients in the U.S. are malnourished, Miller said. To avoid complications, Missouri Baptist dietitians have joined the medical center’s Surgical Evaluation Center team to perform nutrition-focused physical assessments.
“As dietitians, we are available and trained to screen patients upon admission to determine if they are at risk for malnutrition and provide the necessary support if they are diagnosed,” says Miller.
Malnutrition is not always visually apparent, she said. “We use the ASPEN guidelines established to identify factors related to malnutrition, such as weight loss, appetite and adequacy of intake, muscle wasting and reduced functional status.”
Because each person has individualized concerns, the Missouri Baptist dietitians work with patients, their families and clinicians to determine an appropriate nutrition plan based on specific needs. This can range from identifying supplements that are easily consumed for additional calories to recommending tube feeding for those unable to swallow.
Results from the intervention have been promising, Miller said. In 2016, Missouri Baptist dietitians diagnosed more than 2,000 patients with protein-calorie malnutrition — patients not getting enough protein or calories in their diet. Miller says the numbers for 2017 are tracking even higher.
“This dietitian is diagnosing patients preoperatively and has found about 27 percent of surgical patients she sees with symptoms of malnutrition,” Miller says. “Her presence here is making a difference and can help change outcomes.”
In addition to presurgical evaluation, dietitians provide malnutrition assessments for patients on inpatient units across the hospital, as well as through outpatient procedural areas. The Missouri Baptist Outpatient Nutrition Counseling clinic can be utilized to provide education and guidance for improving nutrition health for these individuals.