Nutritional Disorder Clinical Trial
Official title:
Study to Compare Strategies to Improve Detection of Nutritional Disorders in Hospitalized Adults (Compass Project)
The prevalence of malnutrition in hospital is very high (30 percent) with major consequences
in terms of morbidity and mortality, generating significant health care costs. The positive
impact of its support is demonstrated.
The HAS (French High Sanitary Authority) recommends a screening of all adult hospitalized in
the first 48 hours, with no consensus regarding the organization of screening within care
services. Various strategies have been implemented. Although this screening is part of the
nursing role, old and recent studies show that it is not done systematically and nutritional
disorders are largely under-diagnosed and therefore untreated.
The investigators assume that an organization of screening for eating disorders, based on a
caregiver dedicated to this activity, improves the indicator IPAQSS (Indicateurs Pour
l'Amélioration de la Qualité et de la Sécurité des Soins) which is an indicator for the
improvement of the quality and security of care) Screening indicator of nutritional disorders
Level 3, compared to an organization "classic" involving the care teams in their entirety.
This indicator reflects the care system performance.
In this study, patients will have no intervention. Only the organization of the care staff
will be adapted but with no changes on the care of patients?
Undernutrition in the hospital is a public health issue. The impacts of this malnutrition are
known , with consequences clearly established on the morbidity, mortality and quality of
life. Undernutrition is an independent risk factor for mortality (5). In terms of morbidity,
the most frequently reported consequences are infections, postoperative complications
(delayed healing, in particular nosocomial infections, risk of pressure ulcers) and
pejorative impact on the prognosis of chronic diseases such as respiratory failure , heart
and kidney.
Malnutrition therefore affects the length of hospital stays and the burden of care.
Many studies have shown the positive impact of the medical care of malnutrition on morbidity
and mortality, whether intervention studies in general hospital population or in specific
pathologies.
But there is no systematic screening strategy undernutrition implementation in hospitals.
The investigators assume that the organization of screening for eating disorders based on a
caregiver specifically dedicated to this activity, improves the indicator IPAQSS Screening
indicator of nutritional disorders level 3 compared with a "classic" organization shared
between different actors of care. This indicator reflects the care system performance This
organization must advance quickly and significantly the number of patients evaluated
nutritionally and help reach a level of completeness close to 100%.
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