The Importance of Nutrition Screening for Wound Care Patients

It is reported that as many as 35% to 55% of patients entering acute hospitals are at risk of malnutrition. Malnutrition is defined as an imbalance of nutrition1. This includes both under and over-nutrition. Under-nutrition is often seen in developing countries while over-nutrition is more common in developed nations. Malnutrition can develop as a result of a lack of proper nutrition, poor absorption resulting from an illness, excessive nutrient losses, and an increase in nutrition requirements from a disease1. Malnutrition can have disastrous consequences for hospitalized patients including increased hospital stay, higher infection rates, muscle loss, increased morbidity and mortality, and impaired wound healing1. Often times patients are admitted into hospitals already malnourished from their condition. Since undernourishment is difficult to detect, it can go a long time before being discovered.

Malnutrition and the Hospitalized Wound PatientThe best thing a hospitalist can do in this regard is administer a nutrition risk screening. Body composition analyzers such as the seca mBCA 525 (or for patients able to stand, the mBCA 514) should be used for  these screenings to detect undernourishment. Other parameters that can also be identified are losses in lean body mass, skeletal muscle mass, and measuring total body water (hydration) status. These analyzers are also capable of measuring a patient’s phase angle, which can indicate a low range of body cell mass (BCM), pointing to poor nutrition status, or potentially the need for further testing (such as a blood panel for example) to check for other underlying health conditions that may be causing it.

The seca mBCA 525 is  the mobile version of the mBCA 514 that requires the patient to be measured in the supine position, optimal when dealing with bedridden, acute, and wound healing patients under the care of a treatment team that includes a registered dietitian. The healing process slows down significantly with the absence of proper nutrition. The body is incapable of supporting itself without proper nutrients. That is why it’s important for newly-admitted patients to be screened for malnutrition as soon as they are admitted to their acute care facility.

[1] Barker, Lisa A., Belinda S. Gout, and Timothy C. Crowe. “Hospital Malnutrition: Prevalence, Identification and Impact on Patients and the Healthcare System.” International Journal of Environmental Research and Public Health 8.2 (2011): 514-27. National Institutes of Health. Web. 17 Aug. 2016.

Leininger, Susan. “How to Help Wounds Heal.” Ed. Helen Lippman. RN Magazine 1 Aug. 2004: n. pag. Print.

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