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. 2021 Jul 30;13(8):2635.
doi: 10.3390/nu13082635.

Canadian Nationwide Survey on Pediatric Malnutrition Management in Tertiary Hospitals

Koen Huysentruyt  1   2 , Kim Brunet-Wood  3 , Robert Bandsma  1   4 , Leah Gramlich  5 , Bonnie Fleming-Carroll  6 , Brenda Hotson  7 , Rebecca Byers  8 , Heather Lovelace  9 , Rabin Persad  10 , Daina Kalnins  11 , Andrea Martinez  12 , Valerie Marchand  13 , Mélanie Vachon  14 , Jessie M Hulst  1   4 , On Behalf Of The Canadian Malnutrition Task Force-Pediatric Working Group
Affiliations

Canadian Nationwide Survey on Pediatric Malnutrition Management in Tertiary Hospitals

Koen Huysentruyt et al. Nutrients. .

Abstract

Background: Disease-associated malnutrition (DAM) is common in hospitalized children. This survey aimed to assess current in-hospital practices for clinical care of pediatric DAM in Canada. Methods: An electronic survey was sent to all 15 tertiary pediatric hospitals in Canada and addressed all pillars of malnutrition care: screening, assessment, treatment, monitoring and follow-up. Results: Responses of 120 health care professionals were used from all 15 hospitals; 57.5% were medical doctors (MDs), 26.7% registered dietitians (RDs) and 15.8% nurses (RNs). An overarching protocol for prevention, detection and intervention of pediatric malnutrition was present or "a work in progress", according to 9.6% of respondents. Routine nutritional screening on admission was sometimes or always performed, according to 58.8%, although the modality differed among hospitals and profession. For children with poor nutritional status, lack of nutritional follow-up after discharge was reported by 48.5%. Conclusions: The presence of a standardized protocol for the clinical assessment and management of DAM is uncommon in pediatric tertiary care hospitals in Canada. Routine nutritional screening upon admission has not been widely adopted. Moreover, ongoing nutritional care of malnourished children after discharge seems cumbersome. These findings call for the adoption and implementation of a uniform clinical care pathway for malnutrition among pediatric hospitals.

Keywords: child; disease-related malnutrition; nutritional assessment; nutritional screening.

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Conflict of interest statement

J.M.H. received speaker fees for Abbott Nutrition. V.M. declares speaker bureau fees for Nestle, Mead-Johnson, Abbott Nutrition and Takeda. All other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Nutritional screening practices in Canadian tertiary pediatric hospitals by health care profession. RN: registered nurses, RD: registered dietitians, MD: medical doctors, BMI: body mass index, WFA: weight for age, HFA: height for age, NST: nutrition screening tool; results expressed as a proportion of the respondents for this question (n = 59).
Figure 2
Figure 2
Approaches to nutritional assessment in Canadian tertiary pediatric hospitals by health care profession. RN: registered nurses, RD: registered dietitians, MD: medical doctors, BMI: body mass index, WFA: weight for age, HFA: height for age, SGNA: Subjective Global Nutritional Assessment, Strength and Energy: “Assess strength and energy levels”; * option only available for RN and MD; ° option only available to RD; results expressed as a proportion of the respondents for this question (n = 42), multiple answers were allowed.
Figure 3
Figure 3
Interests in further nutrition-related education in Canadian tertiary hospitals by health care profession. RN: registered nurses, RD: registered dietitians; MD: medical doctors; SGNA: Subjective Global Nutritional Assessment; results expressed as a proportion of the respondents for this question (n = 42).
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