The Italian “new deal” of dietetics and clinical nutrition structures

Abstract

Dear readers, On December 17, following the establishment of a board of experts on hospital and nursing home foodservices at the General Directorate for Food and Nutrition Safety, in which the Italian Association of Clinical Dietetics and Nutrition had an essential role, the State-Regional Conference of the Ministry of Health (the Italian Institution which works to promote cooperation between the activities of the state and the autonomy system) approved the Ministry of Health document regarding ‘‘National Guidelines for hospital and nursing home foodservices’’ (downloadable at: http://www. governo.it/backoffice/allegati/61509-6459.pdf) published on G.U. no 37 February 15th, 2011 with the aim of disclosing a model to propose at the national level, in order to homogenize hospital foodservice activities and the activities of the Dietetics and Nutrition Structures in this context. Such document establishes the need to provide the patient with a homogenous process ranging from evaluation of nutritional risk and nutritional state to oral and artificial nutrition (artificial enteric or parenteral nutrition) integrated with adequate overall management of foodservices. In fact, in the document, the Ministry confirms the essential role of operating units of clinical dietetics and nutrition which, by means of foodservice processes and clinical-nutritional practice, can plan and carry out the intense nutritional control essential for achieving overall quality. The document stresses the activity connected with clinical dietetics and nutrition highlighting the frequent dishomogeneity among the various clinical dietetics and nutrition programs, especially notable among the Italian regions and, often, within the same region. Topics treated: nutritional intervention, malnutrition, screening for risk of malnutrition in hospitals and in local structures, nutritional therapy, hospital and extra hospital foodservices, evaluation of nutritional needs, qualitative aspects of foodservices and of the activities of clinical dietetics and nutrition structures. For this purpose, with the aim of evaluating the implementation and efficacy of the national guidelines for hospital and nursing home foodservices in hospitals and local health service facilities, the Ministry requires the activation of a national network of health facilities, in particular of the health directorates, of hospitals and/or local facilities, of hospitalization and care facilities, public and private, of the regions, aimed at monitoring the quality of service, the satisfaction and health condition of the patients as well as health and management costs. Such monitoring must consider: