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Jun 04 2013
The Alliance to Advance Patient Nutrition Releases Nutrition Care Model to Improve Patient Outcomes

Alliance Publishes Joint Consensus Paper that Recommends:

- Redefining clinicians’ roles to include nutrition care
- Implementing comprehensive nutrition interventions and continued monitoring
- Developing comprehensive discharge nutrition care and education plans

June 4, 2013, NEW YORK – The Alliance to Advance Patient Nutrition (the Alliance), an interdisciplinary partnership of five prestigious organizations formed to improve patient outcomes through nutrition intervention, today released its recommended Nutrition Care Model. Presented in a joint consensus paper published online today, in the Journal of Parenteral and Enteral Nutrition and the MEDSURG Nursing Journal, the model offers practical ways in which registered dietitian nutritionists, nurses, hospitalists, physicians and other hospital clinicians can collaborate to promptly diagnose and treat malnourished patients and those at risk for malnutrition.

The paper will also be published in upcoming print issues of the Journal of Parenteral and Enteral Nutrition, the MEDSURG Nursing Journal, and the Journal of the Academy of Nutrition and Dietetics.

Malnutrition is common in the hospital setting, but it is often overlooked. In fact, one in three patients enters the hospital malnourished, -3 which may adversely impact their recovery and increase risk for complications and readmissions.4,5 With healthcare reform placing an urgent emphasis on high quality and affordable care, the Alliance recognizes that by identifying and treating malnourished patients, hospitals can significantly improve patient outcomes while reducing costs and meeting reform provisions.

Nutrition Care Model: Six Principles
The consensus paper, titled "Critical Role of Nutrition in Improving Quality of Care: An Interdisciplinary Call to Action to Address Adult Hospital Malnutrition," represents recommendations from the Alliance emphasizing the following six principles:

  1. Create an institutional culture where all stakeholders value nutrition.
  2. Redefine clinicians’ roles to include nutrition care.
  3. Recognize and diagnose all malnourished patients and those at risk.
  4. Rapidly implement comprehensive nutrition interventions and continued monitoring.
  5. Communicate nutrition care plan.
  6. Develop a comprehensive discharge nutrition care and education plan.

"It is incredibly exciting to offer a novel nutrition care model that clinicians can put into action within their respective hospitals," said Kelly Tappenden, PhD, RD, FASPEN, Alliance representative from the Academy of Nutrition and Dietetics and editor of the Journal of Parenteral and Enteral Nutrition, who also serves as a professor in the Department of Food Science and Human Nutrition at the University of Illinois at Urbana Champaign (UIUC). "Registered dietitian nutritionists working in clinical settings understand very well the obstacles we must overcome to create a culture in which nutrition as a central component of health care is valued. The goal of this model is to break through barriers and get patients the nutrition they need."

Nutrition Challenges within the Inpatient Setting

  • Despite at least one-third of hospitalized patients being admitted malnourished, 1-3 a majority of these patients continue to go unrecognized or unscreened.6
  • In many cases, the responsibility of nutrition lies solely on the dietitian, although many institutions do not have adequate dietitian staffing.
  • While nurses oversee patients 24/7, they are often not included in nutrition care, and physician sign-off is often required to implement a nutrition care plan.

"As a hospitalist, I know of the importance of interdisciplinary collaboration in implementing an effective treatment plan," said Melissa Parkhurst, MD, FHM, an Associate Professor in the Department of Internal Medicine at the University of Kansas Medical Center and medical director of the hospitalist section as well as the medical director of the University of Kansas Hospital Nutrition Support Service. "Nutrition intervention is a low risk, cost-effective strategy to help improve quality of hospital care, and it’s time to join forces to put better nutrition care plans in place."

"Providing effective nutrition intervention requires champions and collaboration among all disciplines involved in patient care," said Beth Quatrara, DNP, RN, ACNS-BC, CMRSN, Alliance representative from the Academy of Medical-Surgical Nurses and Clinical Nurse Specialist with the Digestive Health department at the University of Virginia (UVA) Health System. "Nurses are on the front lines of care, which means we are with the patients and their families every day. It’s not just one person’s job to provide nutrition to patients; it’s everyone’s responsibility."

"In developing the principles in this care model, it was very important to empower all clinicians and focus on the value of nutrition in the hospital setting," said Ainsley Malone, MS, RD, CNSC, LD, President-Elect of A.S.P.E.N. and Nutrition Support Dietitian for Mount Carmel West Hospital in Columbus, OH. "We looked at the challenges hospitals face and recommended ways to quickly screen all patients, immediately provide nutrition intervention when needed, and carry the plan through to discharge."

"Nutrition matters. The time is now to implement a novel, comprehensive nutrition care model that hospitals can leverage to improve patient outcomes and reduce costs," said Gary Fanjiang, MD, MBA, MS, Divisional Vice President, Scientific and Medical Affairs, Abbott Nutrition. "This model was created from an interdisciplinary perspective and leverages proven examples for success."

About the Alliance to Advance Patient Nutrition
The Alliance to Advance Patient Nutrition is an interdisciplinary partnership dedicated to raising awareness about malnutrition and championing for early nutrition screening, assessment and intervention in hospitals. Founded in 2013, the Alliance is comprised of leaders from the Academy of Medical-Surgical Nurses (AMSN), the Academy of Nutrition and Dietetics (AND), the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), the Society of Hospital Medicine (SHM) and Abbott Nutrition. The Alliance to Advance Patient Nutrition is made possible with support from Abbott’s nutrition business.

Media Contact: Michelle Zendah 614-624-7543

1Coats KG et al. J Am Diet Assoc. 1993; 93:27–33.
2Giner M et al. Nutrition 1996; 12:23-29.
3Thomas DR et al. Am J Clin Nutr. 2002; 75: 308-313
4Norman K et al. Clin Nutr. 2008;27:5-15.
5Allaudeen N, et al. J Hosp Med. 2011;6:54-60.
6Elia M, Zellipour L, Stratton RJ. Clin Nutr.2005;24:867-884.

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