THE IMPACT OF NUTRITIONAL INTERVENTIONS ON THE OUTCOMES OF MALNOURISHED OLDER PATIENTS IN ACUTE HOSPITAL SETTINGs

Abstract

Background: Malnutrition is a widespread problem in the geriatric population and high rates of malnutrition have been reported among the older hospitalised patient population. Malnutrition in hospital settings is associated with poor health outcomes for patients such as increased complications and infections, functional decline, poor wound healing, muscle loss and prolonged stay in the hospital, pressure ulcers, and higher mortality and morbidity rate. The use of nutritional interventions reduces mortality, morbidity, complications and the prolonged stay in hospitals by patients with malnutrition. Therefore, identifing nutritional interventions that can improve outcomes of malnourished patients in a hospital setting is essential to obtain sought for health outcomes. Aim: This systematic review aims at identifying and synthesizing the available evidence on the impact of nutritional interventions on the outcomes of malnourished older patients in acute hospital settings Methods: Secondary data analysis of the latest nursing literature published between 2014 and 2019 was conducted to locate the relevant studies from the various electronic database that included PubMed, Medline, The Lancet, CINAHL, Web of science, Wiley library and ERIC databases. The unlimited search yielded a total of 13,457 research studies published in English language. A detailed quality assessment and appraisal yielded six research articles that all met the inclusion criteria. Results: Nutritional interventions such as patient education, dietary modification, oral VI

nutrition supplement, enteral feeding and parenteral feeding had a significant positive impact on aspects such as the body weight, nutritional and functional status, muscle strength, better health outcomes, and reduced health complications, and the mortality rate among malnourished older patients in hospital settings. Oral nutritional supplements and dietary modifications significantly improved on anthropometric measures, especially weight gain and decreased the rate of weight loss. Dietary modifications, enteral feeding and oral nutritional supplements reduces the length of stay at the hospital, mortality rate and also improves clinical outcomes. Conclusion: Based on the findings of this systematic review, it can be concluded that nutritional interventions such as oral nutritional supplements, nutrition screening and nutrition education positively impacted the health of malnourished older patients in a hospital setting. Therefore, leaders in healthcare organisations, nurses and other health practitioners should work collaboratively to implement the appropriate nutritional interventions needed to address malnutrition within hospital settings. Keywords: Malnutrition, hospital setting, nutritional interventions, elderly patients, oral nutritional supplements, nutrition screening, enteral feeding, parenteral feeding,