Older hospitalised patients at risk of malnutrition: correlation with quality of life, aid from the social welfare system and length of stay?

BACKGROUND: malnutrition is regarded as a major risk factor for complications and delayed recovery in hospitalised elderly patients. OBJECTIVE: to examine the prevalence of malnutrition in hospitalised elderly patients and evaluate simple clinical screening criteria. To investigate whether malnutrition was related to lack of care from the health care or social welfare system, quality of life and hospital length of stay (LOS). SETTING: non-acute geriatric hospital. SUBJECTS: 294 elderly patients admitted for rehabilitation after acute hospital care; 244 patients were available for assessment. METHODS: questionnaire interview about nutrition, social network and quality of life. Anthropometric and biochemical measurements, assessment of physical and cognitive function, recording of LOS, discharge destination and diagnosis. RESULTS: 126 patients (51.6%) were at risk of malnutrition using the criteria of body mass index<22 kg/m2 and/or weight loss>or=5%/6 months. Poor quality of life in women (P<0.04) and loss of the health of a spouse (P<0.02) correlated with weight loss. No differences were found in patients at risk regarding LOS, discharge destination, or aid from the social welfare system. CONCLUSIONS: this study confirms a high prevalence of malnutrition risk in hospitalised elderly patients. The health care and social welfare system appeared to be unaware of the problem. Poor quality of life in females and loss of the health of a spouse were related to malnutrition risk. The screening variables that were used appeared not to predict hospital length of stay or discharge destination.

Enhancing the traditional hospital design process: a focus on patient safety.

BACKGROUND: In 2002 St. Joseph's Community Hospital (West Bend, WI), a member of SynergyHealth, brought together leaders in health care and systems engineering to develop a set of safety-driven facility design principles that would guide the hospital design process. DESIGNING FOR SAFETY: Hospital leadership recognized that a cross-departmental team approach would be needed and formed the 11-member Facility Design Advisory Council, which, with departmental teams and the aid of architects, was responsible for overseeing the design process and for ensuring that the safety considerations were met. The design process was a team approach, with input from national experts, patients and families, hospital staff and physicians, architects, contractors, and the community. OUTCOME: The new facility, designed using safety-driven design principles, reflects many innovative design elements, including truly standardized patient rooms, new technology to minimize falls, and patient care alcoves for every patient room. The new hospital has been designed with maximum adaptability and flexibility in mind, to accommodate changes and provide for future growth. The architects labeled the innovative design. The Synergy Model, to describe the process of shaping the entire building and its spaces to work efficiently as a whole for the care and safety of patients. CONCLUSION: Construction began on the new facility in August 2003 and is expected to be completed in 2005.