More-2-Eat: Nutrition care pathway and optimized protein supplementation for malnourished elderly patients
This study demonstrated the importance and impact of investing in food and nutrition care for the recovery of patients. Also, patients can anticipate improved nutrition care in hospitals that implement these best practices.
Possible Research Results
Anticipated findings: Learnings on how to implement this pathway are diverse and will assist other hospitals in Canada with improving their care practices. As a result of implementation of improved nutrition care practices, it is anticipated that patients will be more satisfied with the food they are offered, eat more food and have fewer barriers to food intake while in hospital. It is anticipated that over time this will improve the recovery of patients and their quality of life.
Impact of findings: Successful implementation and resource requirements for improving nutrition care practices will demonstrate to clinical practitioners that it is feasible to make positive changes that positively impact patient care. This study will demonstrate the importance and impact of investing in food and nutrition care for the recovery of frail elderly patients. Patients can anticipate improved nutrition care in hospitals that implement these best practices.
Read more about the More-2-Eat study by clicking here.
About the Project
Almost half of adult patients admitted to Canadian hospitals, and specifically medical and surgical care, are malnourished. This malnutrition develops in the community as a result of social and disease factors. Malnutrition, regardless of its cause, extends the length of the hospital stay and results in readmission if not resolved.
However, an evidence-based best practices algorithm to improve the nutrition care processes has been developed. This algorithm promotes prevention, detection and treatment of malnutrition, as well as improved transitions to the community after hospitalization.
Although designed to be feasible, this best practice algorithm needs to be tested to determine if and how it can be implemented and if patient reported outcomes improve as a result of these improved practices.
More-2-Eat focused on implementing this best practice algorithm in five hospitals (one medical unit each) in four provinces to understand the process of implementation, resource requirements and if it improved patient reported outcomes such as food intake and barriers to intake while in hospital.
A sub study lead by Dr. Adam Rahman focused on determining the feasibility of protein supplementation during and post hospitalization in frail, malnourished elderly. Specifically this study determined recruitment methods, feasibility of measures for function, body composition and strength, as well as compliance with the high protein supplement. Results of this study will be used to develop a large multi-site trial.
Heather Keller, PhD, RD, FDC — University of Waterloo/Schlegel-UW Research Institute for Aging
Adam Rahman, MD — University of Western Ontario
Carlota Basualdo-Hammond, MSc, MPH, RD — Alberta Health Services
Jack Bell, PhD, APD — Metro North Hospital and Health Service, Queensland, Australia
Paule Bernier, PDt, MSc — Ordre professional des diététistes du Québec (OPDQ)
Lori Curtis, PhD — University of Waterloo
Pauline Douglas, BSc, PgCHEP, MBA, MIHM, FHEA, FBDA, RD — UK Need for Nutrition Education/Innovation Programme
Joel Dubin, PhD — University of Waterloo
Donald Duerksen, MD — University of Manitoba
Leah Gramlich, MD, FRCPC — University of Alberta/Alberta Health Services
Daren Heyland — Queen’s University
Manon Laporte, RD — Vitalité Health Network Clinical Nutrition Department
Barbara Liu, MD, FRCPC — Regional Geriatric Program of Toronto
Marko Mrkobrada, MD, FRCPC — University of Western Ontario
Sumantra Ray, MBBS, PGCertMedEd, DipNutr, MPH, MD — UK Need for Nutrition Education/Innovation Programme
Knowledge Users and Partners:
Linda Dietrich, MEd, RD — Dietitians of Canada
Sarah Robbins, MD, MSc, FRCPC — Canadian Nutrition Society/Canadian Malnutrition Task Force
Heather Truber — Canadian Society of Nutrition Management
Néstle Health Science
Regional Geriatric Program of Toronto
UK Need for Nutrition Education/Innovation Programme (NNEdPro)
Project Contact: Heather Keller — firstname.lastname@example.org
Key words: nutrition; malnutrition; hospitals; community; elderly; improvement; care pathway; best practices
Celia Laur, James McCullough, Bridget Davidson, Heather Keller (November 2015). Becoming food aware in hospital: A narrative review to advance the culture of nutrition care in hospitals. Healthcare 3, 393-407pp. MDPI
Celia Laur, Heather Keller (August 2015). Implementing best practice in hospital multidisciplinary nutritional care: an example of using the knowledge-to-action process for a research program. Journal of Multidisciplinary Healthcare 8, 463-472pp. Dove Medical Press
Heather Keller, James McCullough, Bridget Davidson, Elizabeth Vesnaver, Manon Laporte, Leah Gramlich, Johane Allard, Paule Bernier, Donald Duerksen, Khursheed Jeejeebhoy (May 2015). The Integrated Nutrition Pathway for Acute Care (INPAC): Building consensus with a modified Delphi. Nutrition Journal 14
Rationale: Although designed to be feasible, this best practice algorithm needs to be tested to determine if and how it can be implemented and if patient reported outcomes improve as a result of these improved practices.
Objectives: More-2-Eat is focused on implementing this best practice algorithm in five hospitals (one medical unit each) in four provinces to understand the process of implementation, resource requirements and if it improves patient reported outcomes such as food intake and barriers to intake while in hospital.