March 27, 2017

A Letter to the Director of an Internal Review Board (IRB)

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It’s well documented that malnourished patients have longer lengths of stays, higher rates of morbidity and mortality, higher rates of re-admissions, delayed wound healing and higher infection rates.  All impact patient outcome and the bottom line.  There is definitely an “economics of malnutrition”. The information from this day will help us gauge the rate of malnutrition at our facility and help us address these issues through policy and procedural changes and help us increase staff awareness through provider and staff education.

Since the review is completed on an annual basis, we can track our progress and better target our interventions.  This type of review could be used by SMH and Clinical Nutrition as a CMS Quality Assessment/Performance Improvement Initiative (QAPI).

We’re currently in the process of revising the Joint Commission required nutrition screening tool in ConnectCare to an evidenced-based “Malnutrition Screening Tool (MST)” and it is this type of review that will help provide data evidence to support this initiative.

The current Nutrition Day database includes 51 countries, 1787 healthcare facilities and 151,617 patients and has already provided useful data on prolonged NPO (nothing per “oral”) status and how this practice negatively impacts patients and how re-admissions could be impacted and reduced through nutrition counseling.

The Nutrition Day review process and data presentation have been used by other facilities as a Magnet project and we hope to discuss this with NSG for their input and assistance and could certainly be highlighted during a TJC review.

In 2013 the “Alliance to Advance Patient Nutrition” was formed and provides an excellent resource for information on the impact of hospital malnutrition and efforts being made to educate nurses, physicians, patients and dietitians.  The data we collect will help us implement and standardize best practice in BSHSI facilities and be able to benchmark our progress outside the facility.

I hope this helps give greater insight to the importance of our participation in this quality project.

Thank you for your time and thoughtful review.

Barbara Ragland, RD | Clinical Nutrition Manager Bon Secours Richmond Health System | Nutrition Services
5801 Bremo Road | Richmond, VA | 23226
W: 804-287-7793 | F: 804-285-1639 | barbara_ragland@bshsi.org

Good Help to Those in Need(r)