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.
Highlights
Recent studies reported that disease-related malnutrition (DAM), which can be defined as malnutrition in the context of acute and/or chronic disease, is highly prevalent in hospitalized children in North America [1,2,3]
Among the remaining 120 participants, 69 (57.5%) were medical doctors (MDs), 32 (26.7%) registered dietitians (RDs) and 19 (15.8%) RNs; participants were working in general pediatrics, surgery and various subspecialties
Both MDs and RNs were asked to self-score their interest and knowledge about clinical nutrition, and the median (Q1;Q3) scores for MDs (N = 51) were 9 (7;10) and 7 (6;10), respectively; for RN (N = 12) these were 6.5 (5;8) and 4.5 (3;6)
Summary
Recent studies reported that disease-related malnutrition (DAM), which can be defined as malnutrition in the context of acute and/or chronic disease, is highly prevalent in hospitalized children in North America [1,2,3]. There are recommendations available from the WHO and Academy of Nutrition and Dietetics/ASPEN, literature on North American practices of assessment and management protocols for pediatric DAM is lacking. We aimed to survey all tertiary pediatric hospitals in Canada to address all pillars of DAM care in hospitalized children: prevention, screening and assessment, treatment as well as post-hospitalization follow-up. To survey current in-hospital practices for the screening, assessment and management of pediatric DAM in Canadian tertiary hospitals. 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
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