Optimierung des Screenings auf Mangelernährung im Krankenhaus durch „Bottom-up“- und „Top-down“-Strategien – das Krefelder Projekt

Zusammenfassung

Mangelernährung findet sich häufig in deutschen Krankenhäusern. Obwohl die Mangelernährung für die Prognose von Erkrankungen und die ökonomischen Auswirkungen eine immense Bedeutung hat, sind nur in wenigen deutschen Krankenhäusern qualifizierte Ernährungsteams vorhanden. Die systematische Fortbildung der Mitarbeiter mit Beteiligung aller Berufgruppen erscheint zur systematischen Erfassung von Mangelernährung zwingend erforderlich. Diese „Bottom-up“-Strategie beinhaltet die systematische Schulung der Mitarbeiter und die validierte Erfassung der Mangelernährung bereits bei der Aufnahme des Patienten mittels eines EDV-implementierten validierten Fragebogens und nachfolgender Weiterbetreuung durch das Ernährungsteam nach standardisierten Vorgaben. Die Zuweisung verpflichtender Verantwortungsbereiche an die beteiligten Berufsgruppen durch den Klinikträger (Dienstanweisung, „Top-down“-Strategie) erscheint für die flächendeckende Erfassung und effektive Bearbeitung der Mangelernährung hilfreich.

Abstract

Malnutrition is frequently detected in German hospitals. Although malnutrition has significant impact on prognosis of numerous diseases and economic burden professional nutritional support teams (NST) are rarely found. However, systematic screening for malnutrition already after admission appears mandatory. This “bottom up” strategy includes frequent education of physician and nurses to detect malnutrition. This may be accomplished by a computerized and validated questionnaire with consecutive support by the NST in case of malnutrition. In addition, a “top down” strategy with a standing instruction of the employer may be helpful to realize a comprehensive coverage of malnutrition.

Schlüsselwörter

Mangelernährung - Screening - Ernährungsteam

Keywords

malnutrition - screening - nutritional support team

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