Paving the way to detect adult malnourished patients
Hospital malnutrition, particularly disease-related malnutrition (DRM), is a significant public health concern associated with increased morbidity, mortality and costs. Malnutrition often goes undetected in hospitals, particularly in countries such as South Africa, where many people rely on resource-limited public healthcare. When malnutrition is not identified early, it can lead to longer hospital stays, more complications, slower recovery, and higher healthcare costs.
The South African Journal of Clinical Nutrition, Volume 38, Issue one, includes an article titled "Paving the way to detect adult malnourished patients in resource-limited settings: the first step to the right to nutritional care".
"Many patients are already malnourished or at risk when they are admitted to hospital—but without proper nutrition screening and assessment, this often goes unnoticed," noted corresponding author Dr Esmarie van Tonder.
The right to food also includes the right to proper nutritional care for patients in hospital. International efforts like the International Position Paper on Clinical Nutrition and Human Rights and the International Declaration on the Human Right to Nutritional Care, advocate that all hospitalised patients be screened for malnutrition within 24–48 hours of admission. "If patients are at risk or are diagnosed with malnutrition, they should receive timely and appropriate nutrition therapy. This may involve specialised diets, tube feeding, or intravenous nutrition, typically provided by a registered dietitian. Providing this care is not just good clinical practice—it is a basic human right", said Dr van Tonder.
Delivering this care in under-resourced hospitals can be challenging. A lack of equipment to weigh or measure patients, insufficient competency for proper assessments, staff shortages, unclear responsibilities, and the low prioritisation of nutrition in clinical care contribute to the problem.
"The article proposes practical strategies to address some of these challenges—for example, using proxies when the standard measurements required for malnutrition screening and diagnosis are not possible. By improving policies, providing basic equipment and training healthcare staff, even resource-limited hospitals can ensure that patients receive the nutritional care they need and deserve. That would speed up recovery and also reduce overall healthcare costs," continued Dr van Tonder.
This particular study found that widespread adoption and implementation of validated malnutrition screening and diagnostic tools on a global scale would assist in compiling international comparable data on malnutrition prevalence, interventions and outcomes.
Further, the timely identification of malnutrition or risk thereof can safe-guard patients’ right to food, nutritional care and health, while protecting them against the associated negative clinical outcomes.
Read the full article which is published as Open Access here.