Barrieren und Promotoren zum Mangelernährungsscreening

 

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Zusammenfassung

Fragestellung: Mangelernährung (ME) wird in der Praxis in mehr als 50 % der Fälle nicht diagnostiziert und behandelt. ME erhöht die Komplikations- und Mortalitätsrate, verlängert die Spitalaufenthaltsdauer und vermindert die Lebensqualität der betroffenen Patienten. Die vorliegende Literaturübersicht untersucht Barrieren und Promotoren zum ME-Screening in der klinischen Praxis.

Methodik: Systematische Literaturrecherche auf den Datenbanken PubMed, CINAHL und Cochrane. Auswahl der Studien nach inhaltlicher Eignung und deren Qualität. Beurteilung der Studienlage und Diskussion in Bezug auf die allgemeine Literatur bezüglich der Implementierung von evidenzbasierter Praxis (EBP).

Ergebnisse: Sechs Studien wurden in die Literaturübersicht eingeschlossen. Diese zeigen auf, dass sich Barrieren und Promotoren zum ME-Screening vorwiegend auf organisatorische Faktoren wie Personalressourcen, Mentoring und Schulung im Thema beziehen. Die Aufgabenteilung nimmt in diesem interdisziplinären Thema einen äußerst hohen Stellenwert ein.

Schlussfolgerung: Die Studienlage zum Thema ist äußerst spärlich und systematische Erhebungen fehlen fast vollständig. Die Einführung des flächendeckenden ME-Screenings in Institutionen wird aus Qualitäts- und Kostengründen von der WHO sowie der Expertengruppe des Europarats und der Eidgenössischen Ernährungskommission der Schweiz gefordert. Dies erweist sich jedoch als komplex. Die weitere Erforschung von Barrieren und Promotoren und ihren Auswirkungen in Bezug auf die konsequente Anwendung des ME-Screenings ist daher dringend notwendig.

Abstract

Objective: Malnutrition in clinical practice remains undiagnosed and untreated in over 50 % of the cases. It increases in-hospital complications and mortality, length of hospital stay and moreover, it decreases quality of life of those affected. This literature review investigates barriers and facilitators to implementing evidence concerning nutritional screening in clinical practice.

Methods: Systematic literature search on the databases PubMed, CINAHL and Cochrane. Evaluation of the selected literature and discussion in reference to the general literature on implementing evidence into clinical practice.

Results: Six studies were included in this literature review. They revealed that barriers and facilitators to nutritional screening were mostly related to organizational issues like manpower or mentoring and education in nutritional screening. Task sharing issues are of utmost importance regarding this topic of high multidisciplinary.

Conclusion: There are very few studies on barriers and facilitators of nutritional screening and systematic research is lacking almost completely. Implementing nutritional screening on all inpatients is demanded by the World Health Organization, the Public Health Council of Europe and the Swiss Federal Nutrition Committee. However, implementing this recommendation in clinical practice seems challenging. Therefore, further studies of barriers and facilitators to nutritional screening are of high necessity.

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