You can't change what you don't acknowledge.
Joint actions from science to politics reduces malnutrition in the Netherlands
Dutch PEN group: NESPEN – clinical nutrition and metabolism
c/o Cora F. Jonkers- Schuitema RD
secretary NESPEN / Academic Medical Center, Nutrition Support Team A0 115
PO box 22660 NL 1100 DD AMSTEDAM
phone: +3100 20 5665120,
Authors*:
Dutch Malnutrition Steering Group (DMG)
Dr. Ir. HM Kruizenga RD, CF Jonkers - Schuitema RD, Mr. A Evers RD, E van der Heijden RD, W Arjaans RN, Prof. Dr. JJ van Binsbergen MD, Prof. Dr. R Bleichrodt MD, Dr. MAEvan Bokhorst RD, Msc, Drs. F Bolle RN, Dr. K Joosten MD, Prof. Dr. H. Kerkkamp MD, Prof. Dr. PAM van Leeuwen MD, Drs. H. Maas MD, Prof. dr. EMH Mathus- Vliegen MD, W. Remijnse RD, Prof. dr. HP Sauerwein MD, Prof. Dr. Ir. AMWJ Schols, Prof. Dr. JMGASchols MD, Prof. Dr. Ir. M Visser, Prof. Dr. CJJ Mulder MD
Dutch National Prevalence Measurement ofCare Problems (LPZ)
JMMMeijers RN, Msc, Prof. Dr. JMGA Schols, NC van Nie Msc, Dr. MAE van Bokhorst- de van der Schueren PhD, RD, Dr RJG Halfens RN
Rationale
Getting attention is a first step in changing behaviour, confronting professionals with results of their behaviour is likely the strongest key to attention.
The Dutch way to fight disease related malnutrition (DRM) is a two step: Since ‘04 DRM prevalence, screening, treatment and quality indicators are measured yearly by LPZ.
Results are communicatedmultidisciplinary through participating organisations and experts from all health care settings (DMG) with objective toincrease awareness & improve prevention, recognition treatment policy of DRM.
Methods
Since ‘04 LPZ has included more than 20,000 patients per year from hospitals, nursing homes and home care settings. DRM prevalenceis measured at three levels: patient, ward, organisation. Results were presented to Dutch government to raise attention for DRM. Public, physicians, dieticians & nurses were informed through articles, presentations and interactive website.
Results
Malnutrition rates presented in ‘04 and ‘05 prompted the Dutch government to tackle DRM. In ‘06 a grant was received from the Ministry of Health for implementation ofearly DRM screening and treatment in hospitals. Between ’06 - ‘08 over 50% of Dutch hospitals entered the project. For non-participating hospitals a toolkit was made. In ‘07, DRM screening & treatment guidelines were added to the set of national benchmarks. All hospitals are obliged to report:
- % of screened patients
- percentage of DRM
- protein intake on admission day 4.
In chronic care sector (nursing home care and home care) comparable improvement actions have been taken place.
The National improvement program has led tosignificant lower prevalence rates of DRM. Longitudinal, multilevel analysis of LPZ results have shown that organisations participating more years LPZ, DRMrate significantly lowers.
Conclusion
National awareness of DRM is increased since ‘06. Screening DRM has become mandatory practice in Dutch hospitals, nursing homes & home care. The benchmark ‘malnutrition’ makes hospitals, nursing homes and home care organisations eager to score. Managers, physicians, nurses & dieticians are eager to optimise nutritional programs.
The future depends on what we do in the present!
Future
DMG: Outpatient clinics, nursing homes and GP offices.
LPZ: Expand measurement to German-speaking countries.
*Author biography
Dr. Ir. HM Kruizenga RD VU Medical Center Amsterdam, department of dietetics/ projectmanager implementation screening and treatment Malnutrition
Mr. A Evers RD, Institute for quality in healthcare CBO, Utrecht / projectmanager implementation screening and treatment Malnutrition
Drs. J.Meijers RN Department of Health Care and Nursing Science, Faculty of Health, Medicine and Life Sciences, Maastricht University
Drs. N. van Nie RN Department of Health Care and Nursing Science, Faculty of Health, Medicine and Life Sciences, Maastricht University
Dr. R. Halfens, Department of Health Care and Nursing Science, Faculty of Health, Medicine and Life Sciences, Maastricht University
C.F. Jonkers RD Academic Medical Center Amsterdam, nutrition support team
E. van der Heijden RD, PITactief, trainers in education of health and nutrition
Dr. MEA van Bokhorst RD VU Medical Center Amsterdam, department of dietetics
Prof. Dr. JJ van Binsbergen MD, Nijmegen University Medical Center St Radbout, department of General Practice
Prof. Dr. R Bleichrodt MD Nijmegen University Medical Center St Radbout, surgery department
W Arjaans RN VU Medical Center Amsterdam, nutrition support team
Drs. F Bolle RN, society of nurses and education in care V&VN Utrecht
Dr. K Joosten MD, Erasmus Medical Center Rotterdam, department of pediatrics
Prof. Dr. H. Kerkkamp MD, University Medical Center Utrecht, department of geriatrics
Prof. Dr. PAM van Leeuwen MD VU Medical Center Amsterdam, surgery department
Drs. H. Maas MD, Twee Steden Ziekenhuis Tilburg, managing director
Prof. dr. EHM Mathus- Vliegen MD, Academic Medical Center Amsterdam, department of gastroenterology
W. Remijnse RD, Dutch Dietetic Society, Quality manager
Prof. dr. HP Sauerwein MD, Academic Medical Center Amsterdam, department of internal medicine / endocrinology
Prof. Dr. Ir. AMWJ Schols, University of Maastricht, department of pulmonary diseases
Prof. Dr. Ir. M Visser VU Medical Center Amsterdam, department of dietetics
Prof. Dr. CJJ Mulder MD VU Medical Center Amsterdam, department of gastroenterology / Chairman of Dutch society of gastro-enterology
Prof. Dr. J.M.G.A. Schols MD, Department of General Practice, Maastricht University; Scientific Centre for Transformation in Care and WelfareTranzo, Tilburg University
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You can't change what you don't acknowledge.
Joint actions from science to politics reduces malnutrition in the Netherlands