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Organisation of Nutritional Support in Hospitals. Nutrition steering committee and nutrition support teams – needs, structure and roles

Chairman and Editor: Dr DBA Silk.

Summary of Findings

  • Malnutrition in diseased patients delays recovery, increases the incidence of serious complications and significantly increases treatment costs.
  • While the most cost-effective approach to overcoming malnutrition is to encourage patients to eat more normal food, it is not always possible to achieve this and in such cases nutritional support via oral supplements, enteral tube feeding or parenteral nutrition can radically improve recovery rate and quality of life.
  • Over two-thirds of UK hospitals currently have no formal nutrition team responsible for organising the diagnosis, treatment and monitoring of malnutrition and in hospitals that do have a team, some only cover parenteral nutrition and some operate only in specific specialties such as surgery.
  • There is good evidence that there are significant benefits where a fully operational multidisciplinary nutrition support team is established; reduction in catheter complications, metabolic complications and morbidity, improved achievement of prescribed goals for nutrient intake and clinical outcomes, and reduced hospital stay arising from the above benefits, plus the implementation of home nutritional support services.
  • These improvements can have significant associated cost savings.

Recommendations

  • All patients in UK hospitals who are diagnosed as being malnourished or at risk of developing malnutrition should have access to a nutrition support team.
  • All patients who are at risk of being malnourished should be routinely screened for malnutrition either prior to or on admission to hospital.
  • All major UK hospitals or hospital groups should appoint a Nutrition Steering Committee (NSC) to be responsible for setting standards for and delivery of catering services, dietary supplements and nutritional support.
  • All NSCs should appoint at least one Nutrition Support Team (NST) to implement the standards of nutritional support laid down by the NSC.
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