Detection of nosocomial malnutrition is improved in Amazon region by a standard clinical nutrition education program.

BACKGROUND: In Brazil hospital malnutrition is highly prevalent, physician awareness of malnutrition is low, and nutrition therapy is underprescribed. One alternative to approach this problem is to educate health care providers in clinical nutrition. The present study aims to evaluate the effect of an intensive education course given to health care professionals and students on the diagnosis ability concerning to hospital malnutrition. MATERIALS AND METHODS: An intervention study, based on a clinical nutrition educational program, offered to medical and nursing students and professionals, was held in a hospital of the Amazon region. Participants were evaluated through improvement of diagnostic ability, according to agreement of malnutrition diagnosis using Subjective Global Assessment before and after the workshop, as compared to independent evaluations (Kappa Index, k). To evaluate the impact of the educational intervention on the hospital malnutrition diagnosis, medical records were reviewed for documentation of parameters associated with nutritional status of in-patients. The SPSS statistical software package was used for data analysis. RESULTS: A total of 165 participants concluded the program. The majority (76.4%) were medical and nursing students. Malnutrition diagnosis improved after the course (before k = 0.5; after k = 0.64; p < 0.05). A reduction of false negatives from 50% to 33.3% was observed. During the course, concern of nutritional diagnosis was increased (chi2 = 17.57; p < 0.001) and even after the course, improvement on the height measurement was detected (chi2 = 12.87; p < 0.001). CONCLUSIONS: Clinical nutrition education improved the ability of diagnosing malnutrition; however the primary impact was on medical and nursing students. To sustain diagnostic capacity a clinical nutrition program should be part of health professional curricula and be coupled with continuing education for health care providers.

Detection of nosocomial malnutrition is improved in Amazon region by a standard clinical nutrition education program / Mejora del diagnóstico de desnutrición hospitalaria a través de un programa de educación en nutrición clínica en la región Amazónica

Background: In Brazil hospital malnutrition is highly prevalent, physician awareness of malnutrition is low, and nutrition therapy is underprescribed. One alternative to approach this problem is to educate health care providers in clinical nutrition. The present study aims to evaluate the effect of an intensive education course given to health care professionals and students on the diagnosis ability concerning to hospital malnutrition. Materials and methods: An intervention study, based on a clinical nutrition educational program, offered to medical and nursing students and professionals, was held in a hospital of the Amazon region. Participants were evaluated through improvement of diagnostic ability, according to agreement of malnutrition diagnosis using Subjective Global Assessment before and after the workshop, as compared to independent evaluations (Kappa Index, k). To evaluate the impact of the educational intervention on the hospital malnutrition diagnosis, medical records were reviewed for documentation of parameters associated with nutritional status of in-patients. The SPSS statistical software package was used for data analysis. Results: A total of 165 participants concluded the program. The majority (76.4%) were medical and nursing students. Malnutrition diagnosis improved after the course (before k = 0.5; after k = 0.64; p < 0.05). A reduction of false negatives from 50% to 33.3% was observed. During the course, concern of nutritional diagnosis was increased ( X2= 17.57; p < 0.001) and even after the course, improvement on the height measurement was detected (X2 = 12.87; p < 0.001). Conclusions: Clinical nutrition education improved the ability of diagnosing malnutrition; however the primary impact was on medical and nursing students. To sustain diagnostic capacity a clinical nutrition program should be part of health professional curricula and be coupled with continuing education for health care providers (AU)

Antecedentes: En el Brasil, la desnutrición en hospitales es alta, la conciencia médica al respecto de la desnutrición es pequeña y la terapia nutricional es poco recetada. Una de las alternativas para tratar el problema es educar a los profesionales de la salud en nutrición clínica. El presente estudio tiene por objetivo evaluar el efecto de un curso intensivo para profesionales y estudiantes de la salud, en su habilidad de diagnosticar la desnutrición en hospitales. Materiales y métodos: Un estudio de intervención con base en un programa de educación clínica fue ofrecido a estudiantes y profesionales de medicina y de enfermería y realizado en un hospital de la región Amazónica. Los participantes fueron evaluados a través del mejor rendimiento de su capacidad diagnóstica, conforme los diagnósticos de desnutrición utilizando Evaluación Subjetiva Global, antes y después del curso. Para determinar el impacto de la intervención educacional en el diagnóstico de la desnutrición hospitalaria, se revisaron las historias clínicas en busca de parámetros asociados al estado nutricional de los pacientes hospitalizados. El programa de estadística SPSS fue usado para el análisis de datos. Resultados: Un total de 165 participantes concluyeron el programa. La mayoría (76,4%) eran estudiantes de medicina y enfermería. El diagnóstico de la desnutrición mejoró después del curso (antes k = 0,5; después k = 0,64: p < 0,05). Se observó una reducción de falsos negativos de 50% para 33,3%. Durante el curso, la conciencia sobre el diagnóstico nutricional aumentó e, incluso después del curso, mejoró la determinación de las medidas de altura. Conclusiones: El programa de educación clínica mejoró la capacidad de diagnosticar la desnutrición, sin embargo, el impacto mayor fue sobre los estudiantes de medicina y enfermería. Para mantener la capacidad de diagnosticar, un programa en nutrición clínica debería formar parte del currículo de las profesiones de la salud junto a su programa de educación continuada (AU)