Today @ MAND – Malnutrition Awareness Week 2020

October 9th, 2020

This week we celebrate Malnutrition Awareness Week – a campaign spearheaded by our colleagues at ASPEN. Hear Dana Steinmetz write about the impact of a multidisciplinary team approach on malnutrition in an acute care hospital. Jessie Seltz and Kelly Siverhus also share updates from the MSDA.


The Malnutrition Quality Improvement Initiative (MQii)

Based on consensus in scientific literature, malnutrition rates range between 29-53% in acute care hospitals. 1 In response to the poor outcomes correlated with malnutrition in acute care patients, work groups from various organizations have come together to increase malnutrition awareness. The Malnutrition Quality Improvement Initiative (MQii) is composed of experts from the Academy of Nutrition and Dietetics, Avalere Health, and many other collaborators. Their mission is to “advance evidence-based, high-quality patient-driven care for hospitalized older adults (age 65 and older) who are malnourished or at-risk for malnutrition.”2 Of note, while the initial focus is on older adults, efforts are underway to include all age groups in the initiative. Through the implementation of the MQii toolkit, the MQii organization hopes to 1) achieve interdisciplinary malnutrition standards, 2) implement malnutrition best practices in healthcare organizations, and 3) improve patient nutrition risk identification and care.2 The toolkit promotes a six-step malnutrition care workflow and includes:

  1. Screening
  2. Assessment
  3. Diagnosis
  4. Care plan development
  5. Intervention implementation
  6. Monitoring/evaluation & discharge planning.3

A pilot study conducted by Silver et al4 in 2018 investigated the effectiveness of the MQii tool kit on malnutrition care at Vanderbilt University Hospital in Nashville, TN. After a three-month MQii intervention and training program, they found that knowledge surrounding malnutrition in the hospital increased from 39% to 53% (P = 0.009). Other interesting results included an 11.6% increase in diagnosis of malnutrition in the patient’s medical record by a physician, and 95% of patients at risk for malnutrition received a documented intervention.4 The MQii combines the work of diverse interest groups collaborating towards a shared goal of reducing hospital malnutrition rates. While many hospitals implement portions of this initiative, the MQii emphasizes a multidisciplinary approach with involvement from dietitians, nurses, and physicians. As acute care dietitians we are responsible for assessing patients, communicating our findings, and advocating interventions for our patients.

If you would like to learn more about the MQii you can find additional information on their website: http://malnutritionquality.org/index.html and from the Academy of Nutrition and Dietetics: https://www.eatrightpro.org/practice/quality-management/quality-improvement/malnutrition-quality-improvement-initiative

References:

1. Sulo S, Feldstein J, Partridge J, Schwander B, Sriram K, Summerfelt T. Budget impact of a nutrition-focused quality improvement program for malnourished hospital patients. Am Health Drug Benefits. 2017;10(5):262-269. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5620506/.
2. About the MQii. Malnutrition Quality Improvement Initiative [Web]. 2018. Available at: http://mqii.defeatmalnutrition.today/about-mqii.html
3. Valladares A. Introduction to the Malnutrition Quality Improvement Initiative (MQii). MQii Learning Collaborative. October 2018. Webinar
4. Silver H, Pratt K, Bruno M, Lynch J, Mitchell K, McCauley S. Effectiveness of the Malnutrition Quality Improvement Initiative on practitioner malnutrition knowledge and screening, diagnosis, and timeliness of malnutrition-related care provided to older adults admitted to a tertiary care facility: A pilot study. J Acad Nutr Diet. 2018;118(1):101-109. doi: 10.1016/j.jand.2017.08.111.

Dana Steinmetz, RD, LDN serves as your Director-Elect of Member Communications and currently works as a clinical dietitian in a large Boston-based hospital. She has been working in the field of nutrition and dietetics for one year and has loved every moment! When nutrition is not on her mind, she can be found playing beach volleyball, binge watching The Office on Netflix (likely for the 10th time) or exploring all that Boston has to offer.


What has the MSDA been up to and how are students adapting virtually?

In today’s world of technology, students are able to start-up their computers and attend classes with ease. Events are hosted through video platforms, classes are attended from bedrooms, and some dietetic internship rotations are completed online. In some cases, this provides benefit; Lily Spik, a student at Boston University, and the Social Media Chair of the MSDA, says that “as a student who learns best independently or in a small group, being able to turn off my computer and focus between classes is really nice.” While this aspect of virtual learning may be beneficial, the sense of community and involvement students gain within their schools and programs proves challenging to sustain. Emily Burrow, a student at Framingham State, and Treasurer of the MSDA states “I find that I am still learning a lot from professors who have adapted to the situation… [but] I don’t feel as connected to the school anymore.” In addition, Reem Hawary, a student at Tufts Friedman School for Nutrition, Science, and Policy, said “being new at Friedman, and not knowing anyone, it is much harder to have connections with other students. It is this feeling of being alone in your struggles and not knowing who to ask the simple questions.” As the MSDA, we feel it is crucial to step into our roles with full force this year. We strive to provide students ways to create and maintain connections with their peers and the rest of the nutrition and dietetics community. This year, we decided to take advantage of a fully virtual platform and use it as an opportunity to involve as many students as possible from the New England area and the field of nutrition and dietetics. In addition, although we may not be able to volunteer in-person, we are making it an initiative of ours to continue to support and contribute to our local community.

We started off the year cooking a delicious Pumpkin Alfredo Pasta alongside our members during our Virtual “Kick-Off Kitchen” event. Check out our Instagram (@massrd2be) for the recipe! Our next upcoming event is the first of a new series of webinars that will host expert speakers from different specialties, skills, and areas of interest in the field of nutrition and dietetics. We aim to include speakers who specialize in Pediatrics, Diabetes, Research, Corporate Wellness, Communication, and Social Media among other areas. Our first planned webinar is a pediatrics-focused webinar on Oct. 7th at 7pm, hosted by Kristi King, MPH, RDN, LD, CNSC, the senior Pediatric Dietitian at Texas Children’s Hospital. The link to sign-up for this event is available in our Instagram Bio, our weekly newsletter, or can be received by email! All of our webinars will be recorded and posted on the MSDA webpage to view for those unable to attend. Finally, our annual Dietetic Internship Selection Workshop (DISW) will be hosted virtually through Zoom this year. This event has proven extremely helpful and beneficial for prospective interns, and we want to continue to provide this great networking opportunity to students. This will take place on Oct. 30th starting at 4pm

Jessie Seltz (Right) is the current President of the MSDA and Kelly Siverhus (Left) is the current Vice President of the MSDA. They are both senior interns in the Tufts Master of Science and Dietetic Internship at Tufts Medical Center and the Friedman School of Nutrition Science and Policy. Jessie completed her undergraduate degree at the University of Connecticut and currently hopes to pursue a career in dietetics working as an inpatient dietitian focused in pediatric and infant nutrition. Kelly completed her undergraduate degree at the University of Wisconsin-Madison. She hopes to work as an outpatient dietitian with specific interests in chronic disease management and inborn errors of metabolism.


Do you want to contribute to the MAND Blog?

We just ask that it is less than 500 words, and you please submit a photo with a short personal biography to include with the post.

Consider writing your own feature article and send your submission to Sierra Parker and Dana Steinmetz, editors of Today@MAND: newsletter@eatrightma.org.

Posted by: Maureen Kelly Gonsalves

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