An European survey of structure and organisation of nutrition support teams in Germany, Austria and Switzerland.

BACKGROUND & AIMS: Nutritional support teams (NST) have been demonstrated to be an excellent mechanism for identifying patients in need of nutrition support, improving the efficacy of nutrition support in a variety of hospital environments. Focus of this study was the investigation of function, structure and organisation of NST in Germany (D), Austria (A) and Switzerland (CH). METHODS: Prospective investigation of the function, structure and organisation of NST in D, A and CH, using standardised questionnaires. RESULTS: From a total of 3071 hospitals in D, A and CH, NST have been established at 98 hospitals (3.2%). Their main activities were creating nutritional regimes (100%), education (87%) and monitoring nutrition therapy (92%). In general, the NST are not independently operating units but are affiliated to a special discipline. Seventy-one per cent of the physicians, 40% of the nurses and 69% of the dieticians in the NST held a nutrition-specific additional qualification. A total of 12% of the physicians, 37% of the nurses and 46% of the dieticians are exclusively responsible for the NST. A reduction of complications (88%) and cost saving (98%) were indicated since their establishment. The NST received in 32% funding support. CONCLUSION: In D, A, CH neither a uniform nor comprehensive patient care by NST existed in 2004. Standards of practice, development of guidelines in clinical nutrition and better documentation in NSTs are necessary. Special efforts should be aimed at education of NST members and financing of teams.

Hospital food: a survey of patients' perceptions.

BACKGROUND & AIMS: Most hospitalised patients are dependent on hospital food for their nutritional requirements. We surveyed hospitalised patients to obtain their opinions of hospital food in order to improve menu planning and food delivery. METHODS: Three hundred and seventeen questionnaires were distributed to patients on an oral diet in two Swiss hospitals. Questions assessed eating habits, appetite, satisfaction with menus, food preferences and presentation, understanding of choices available and preferred choices. RESULTS: Three hundred and nine (97.5%) questionnaires were completed and analysed. Two hundred and sixty-five (86%) respondents were satisfied or very satisfied with hospital food. Two hundred and forty-one (78%) were satisfied with the way in which the food was served. There was a negative correlation (P=0.005) between duration of hospital stay and satisfaction with the food provided: 121 (39%) respondents stated that their appetite was the same as at home, and 50% stated that it had decreased during their time in the hospital. Eighty-seven (28%) patients said they ate all the food served, 148 (48%) ate most of it, and 68 (22%) ate only a small proportion. Patients felt that the temperature, appearance and aroma of the food were particularly important. CONCLUSION: Based on the findings of this survey we have made recommendations for improvements in hospital food and its presentation.

Albumin but not fibrinogen synthesis correlates with galactose elimination capacity in patients with cirrhosis of the liver.

Albumin and fibrinogen synthesis rates were measured in 15 subjects with different clinical stages of postviral cirrhosis and compared with galactose elimination capacity and aminopyrin breath test. Forty-three mg per kg body weight [2H5ring]phenylalanine with an isotopic enrichment of 10 atom% were intravenously injected. [2H5ring]phenylalanine enrichments in the plasma-free phenylalanine and the albumin and fibrinogen isolates were measured by gas chromatography-mass spectrometry. Fractional synthesis rates of albumin were normal in Child A cirrhosis (7.6 +/- 2.2%d), but were lower in both Child B (3.5 +/- 0.8%d) and C (4.5 +/- 2.8%d). Absolute rates of albumin synthesis were (103 +/- 30 mg/kg/d) in the child A group and substantially lower in the Child B (50 +/- 3 mg/kg/d) and C (36 +/- 20 mg/kg/d) group. The average fractional synthesis rate of fibrinogen was 16.7 +/- 7.5%d and the absolute synthesis rate 11.6 +/- 6.4 mg/kg/d. The values of the galactose elimination capacity and the aminopyrin breath test were below the normal range in all patients, gradually decreasing with an increase in the severity of the clinical stage of cirrhosis. Albumin synthesis rates significantly correlated with the Child scores, the galactose elimination capacity, and the aminopyrin breath test, whereas fibrinogen synthesis rates showed no such correlations.