Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jan;46(1):141-152.
doi: 10.1002/jpen.2068. Epub 2021 Mar 29.

Consensus-based nutrition care pathways for hospital-to-community transitions and older adults in primary and community care

Heather Keller  1   2 , Rachael Donnelly  1 , Celia Laur  3   4 , Leila Goharian  5 , Roseann Nasser  6
Affiliations
Review

Consensus-based nutrition care pathways for hospital-to-community transitions and older adults in primary and community care

Heather Keller et al. JPEN J Parenter Enteral Nutr. 2022 Jan.

Abstract

Background: Practical guidance for providers on preventing, detecting, and treating malnutrition in primary care (PC) and the community is limited. The purpose of this study was to develop nutrition care pathways for adult patients (aged ≥18 years) transitioning from hospital to community and community-dwelling older adults (aged ≥65 years) who are at risk for malnutrition.

Methods: A review of best-practice nutrition evidence and guidelines published between 2009 and 2019 was performed using PubMed and CINAHL. Findings were summarized into two draft care pathways by the Primary Care Working Group of the Canadian Malnutrition Task Force. Diverse stakeholders (n = 21) reviewed and suggested revisions at a 1-day meeting. Revisions were made and an online survey was conducted to determine the relevance and importance of discrete care practices, and to establish consensus for which practices should be retained in the pathways. Providers (e.g., dietitians, physicians, nurses; n = 291) across healthcare settings completed the survey. Consensus on relevance and importance of practices was set at ≥80%.

Results: One hundred twenty-eight resources were identified and used to develop the draft pathways. Survey participants assigned ratings of ≥80% for relevance and importance for all nutrition care practices, except community service providers monitoring patient weight and appetite.

Conclusion: These evidence- and consensus-based nutrition pathways offer guidance to healthcare and service providers on how to deliver nutrition care during hospital-to-community transitions for malnourished adult patients and community-dwelling older adults at risk for malnutrition. These pathways are flexible for diverse PC and community models.

Keywords: acute care; adult; care pathway; community; healthcare transition; hospital; malnutrition; malnutrition risk; older adult; primary care.

PubMed Disclaimer

References

    1. Keller HH, McCullough J, Davidson B, et al. The integrated nutrition pathway for acute care (INPAC): building consensus with a modified Delphi. Nutr J. 2015;14(1):63.
    1. Valaitis R, Laur CV, Keller HH, Butterworth D, Hotson B. Need for the Integrated Nutrition Pathway for Acute Care (INPAC): gaps in current nutrition care in five Canadian hospitals. BMC Nutr. 2017;3(1):60.
    1. Keller HH, Valaitis R, Laur CV, et al. Multi-site implementation of nutrition screening and diagnosis in medical care units: success of the more-2-eat project. Clin Nutr. 2019;38(2):897-905.
    1. Laur CV, Keller HH, Curtis L, Douglas P, Murphy J, Ray S. Comparing hospital staff nutrition knowledge, attitudes, and practices before and 1 year after improving nutrition care: results from the more-2-eat implementation project. JPEN J Parenter Enteral Nutr. 2018;42(4):786-796.
    1. Keller HH, Laur CV, Atkins M, et al. Update on the Integrated Nutrition Pathway for Acute Care (INPAC): post implementation tailoring and toolkit to support practice improvements. Nutr J. 2018;17(1):1-6.

Publication types

LinkOut - more resources