Article

State of malnutrition in Cuban hospitals.

Grupo de Apoyo Nutricional, Hospital Clínico-Quirúrgico Hermanos Ameijeiras, Havana, Cuba.
Nutrition (impact factor: 3.03). 04/2005; 21(4):487-97. DOI:10.1016/j.nut.2004.08.019
Source: PubMed

ABSTRACT We assessed the current state of undernutrition as observed in 1905 patients hospitalized in 12 Cuban health care institutions, as part of a Latin American, multinational survey similar in design and goals.
We surveyed 1905 randomly selected patients from 12 Cuban hospitals in a two-phase study. Patients' clinical charts were audited in phase 1, the Subjective Global Assessment was used to assess patients' nutritional status in phase 2. The study was locally conducted by a properly trained team.
The frequency of undernutrition in Cuban hospitals was 41.2% (95% confidence interval = 38.9 to 43.4), and 11.1% of patients were considered severely undernourished. Statistically significant (P < 0.05) univariate relations were identified between undernutrition and patient's age and sex. Nutritional status was a dependent of the patient's instruction level (P < 0.05). Patients' nutritional status was statistically associated with the presence of cancer and infection. Undernutrition was highly prevalent among cancer patients, no matter the stage of medical or surgical treatment. Undernutrition became extremely frequent after surgical treatment in non-cancer patients. High nutritional risks hospital services/specialties were identified: geriatrics (56.3%), critical care (54.8%), nephrology (54.3%), internal medicine (48.6%), gastroenterology (46.5%), and cardiovascular surgery (44.8%). Malnutrition rates increased progressively with prolonged length of stay.
A high malnutrition rate was observed among participating hospitals. The design and inception of policies that foster intervention programs focusing on early identification of hospital malnutrition and its timely management is suggested to decrease its deleterious effects on outcomes of health care in the participating hospitals.

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  • Article: Gauging food and nutritional care quality in hospitals.
    Rosa Wanda Diez-Garcia, Anete Araújo de Sousa, Rossana Pacheco da Costa Proença, Vania Aparecida Leandro-Merhi, Edson Zangiacomi Martinez
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    ABSTRACT: Food and nutritional care quality must be assessed and scored, so as to improve health institution efficacy. This study aimed to detect and compare actions related to food and nutritional care quality in public and private hospitals. Investigation of the Hospital Food and Nutrition Service (HFNS) of 37 hospitals by means of structured interviews assessing two quality control corpora, namely nutritional care quality (NCQ) and hospital food service quality (FSQ). HFNS was also evaluated with respect to human resources per hospital bed and per produced meal. Comparison between public and private institutions revealed that there was a statistically significant difference between the number of hospital beds per HFNS staff member (p = 0.02) and per dietitian (p < 0.01). The mean compliance with NCQ criteria in public and private institutions was 51.8% and 41.6%, respectively. The percentage of public and private health institutions in conformity with FSQ criteria was 42.4% and 49.1%, respectively. Most of the actions comprising each corpus, NCQ and FSQ, varied considerably between the two types of institution. NCQ was positively influenced by hospital type (general) and presence of a clinical dietitian. FSQ was affected by institution size: large and medium-sized hospitals were significantly better than small ones. Food and nutritional care in hospital is still incipient, and actions concerning both nutritional care and food service take place on an irregular basis. It is clear that the design of food and nutritional care in hospital indicators is mandatory, and that guidelines for the development of actions as well as qualification and assessment of nutritional care are urgent.
    Nutrition Journal 09/2012; 11:66. · 2.48 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

12 Cuban health care institutions
 
12 Cuban hospitals
 
95% confidence interval
 
cancer patients
 
critical care
 
Cuban hospitals
 
foster intervention programs
 
health care
 
hospital malnutrition
 
internal medicine
 
malnutrition rate
 
non-cancer patients
 
nutritional risks hospital services/specialties
 
participating hospitals
 
Patients' clinical charts
 
patients' nutritional status
 
Statistically significant
 
Subjective Global Assessment
 
surgical treatment
 
timely management
 

Jesús Barreto Penié