Malnutrition Management in a Canadian Hospital with the Integrated Nutrition Pathway for Acute Care (INPAC).

All malnourished patients in both study years received a nutritional care plan from a dietitian during hospitalization.

• 100% of malnourished patients in both 2017 and 2019 were provided with a nutritional care plan by a dietitian during their hospitalization.
• A total of 158 patients were identified as malnourished in 2017 and 122 patients in 2019.
• Data were collected from retrospective chart audits using electronic medical records across nine acute care units.
• The INPAC algorithm was used to guide nutritional care planning.

Nutritional discharge planning increased from 2017 to 2019.

• Nutritional discharge planning was provided to 46 patients (29%) in 2017 and 53 patients (43%) in 2019.
• Despite the increase, only approximately half of malnourished patients received a nutrition care plan at discharge in either year.
• This represents an increase of approximately 14 percentage points between the two study years.

Oral nutritional supplements (ONS) at mealtime remained the most commonly used nutritional intervention during hospitalization in both study years.

• ONS at mealtime were used for 106 patients (67.1%) in 2017 and 81 patients (66.4%) in 2019.
• The rate of ONS use at mealtime was nearly identical across both years.
• ONS at mealtime was the most frequently applied intervention among all in-hospital nutritional strategies in both years.

Assistance of a dietetic technician became as frequently used as ONS at mealtime by 2019.

• Dietetic technician assistance was used for 81 patients (66.4%) in 2019, matching the rate of ONS use at mealtime in the same year.
• This reflects a notable increase in the role of dietetic technicians in nutritional care between 2017 and 2019.
• The equivalence of these two interventions in 2019 represents a change in the distribution of nutritional care strategies compared to 2017.

Referring patients to an outpatient clinic was the most frequently used nutritional intervention during discharge planning in both years, and increased between 2017 and 2019.

• Outpatient clinic referrals were made for 20 patients (43.5%) of those with discharge plans in 2017 and 35 patients (66.0%) in 2019.
• This represented an increase of approximately 22.5 percentage points in the proportion of discharge-planning patients referred to outpatient clinics.
• Outpatient clinic referral was the most common of all discharge planning interventions in both study years.