Abstract
Introduction: Nutrition status among older adults is an important factor in health and clinical outcomes but malnutrition goes unrecognised in routine health care. Older adults often present to emergency departments (ED) and are subsequently discharged without hospital admission. Discharge is a transitionary time of care when nutritional vulnerability could be mitigated with the instigation of targeted nutrition care pathways. This protocol outlines a scoping review to identify the level of nutrition care provided to older adults attending emergency departments. Methods: This scoping review will be conducted using the framework proposed by the Joanna Briggs Institute. The Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR) will be used to guide the reporting. Two researchers will search electronic databases (Medline, CINAHL Complete, EMBASE, Cochrane Library and Scopus), grey literature sources (DART-Europe E-theses portal, Open Grey, and Trip Medical database) and website searches (Google, Google Scholar, Pubmed, NICE and LENUS) to identify appropriate data for inclusion within the last 10 years. Key information will be categorised and classified to generate a table charting the level of nutrition and dietetic care initiated for older adults in the ED according to the Nutrition Care Process Model. A narrative synthesis will be conducted. Conclusions: This scoping review will be used to inform a foundational concept of nutrition care in an ED setting and allow the future examination of nutrition care pathways, practice, policy, and research within models of integrated care for older persons.
Highlights
Nutrition status among older adults is an important factor in health and clinical outcomes but malnutrition goes unrecognised in routine health care
We have previously reported finding over a third of non-acute older adults admitted and subsequently discharged from emergency departments (ED) to be at risk of malnutrition or malnourished when screened with the Mini Nutritional Assessment – Short Form (MNS-SF) tool (Griffin et al, 2020)
There are missed opportunities to initiate integrated care pathways to ameliorate nutrition vulnerability (Starr et al, 2015; Umegaki et al, 2017; Vivanti et al, 2015). The purpose of this proposed scoping review is to identify the extent of nutrition care provided to older adults attending and subsequently discharged from ED. This information will be used to inform a foundational concept of nutrition care according to the Nutrition Care Process Model (NCPM) in an ED setting and allow the future examination of nutrition care pathways, practice, policy, and research within models of integrated care for older adults
Summary
The process of ageing has an impact on the nutritional status of an individual. This can occur due to factors such as the physiological (e.g. taste changes, poor dentition, loss of appetite, mobility and functional limitations), psychosocial (e.g. life course, food ideals and preferences, grief and bereavement), and personal resources (e.g. transport, disposable income, social supports) that influence food choice and intake (Host et al, 2016; Stanga, 2009) among older adults. Screening is described as the first step to identify “at risk” of malnutrition status with the use of a validated malnutrition screening tool This process serves to identify those who require targeted assessment and nutrition interventions (Cederholm et al, 2019; Swan et al, 2017; Swan et al, 2019). There are missed opportunities to initiate integrated care pathways to ameliorate nutrition vulnerability (Starr et al, 2015; Umegaki et al, 2017; Vivanti et al, 2015) The purpose of this proposed scoping review is to identify the extent of nutrition care provided to older adults attending and subsequently discharged from ED. A scoping review has been chosen to explore the breadth of grey and published literature to provide a holistic synthesis of evidence and identify research gaps and focus for future studies
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