The goal of this clinical trial is to learn whether a new way of organising hospital nutrition care can improve outcomes for adults who are admitted to medical wards and are at risk of malnutrition.
The main questions it aims to answer are:
* Does having clinical dietitians take primary responsibility for nutrition care shorten hospital stay? * Does this approach improve nutritional intake, nutritional status, quality of life, and patient satisfaction? * Does this approach lower healthcare costs compared with current practice?
Researchers will compare the new nutrition care model with current practice. In current practice, nursing staff are mainly responsible for nutrition screening and nutrition care planning, while clinical dietitians are involved only when requested. In the new model, clinical dietitians are part of the ward team and take primary responsibility for identifying patients at nutritional risk, planning nutritional care, and providing nutritional treatment.
Participants will:
* Receive either the current nutrition care approach or the new dietitian-led nutrition care approach, depending on when they are admitted to the ward * Complete questionnaires about their nutritional status, quality of life, and daily activities during their hospital stay and about 30 days later * Have information collected during their hospital stay and from their medical records, including nutritional intake, body weight, length of hospital stay, hospital readmissions, and other health outcomes
The study will be conducted on three medical wards at Gødstrup Hospital. All wards will start with current practice and will gradually change to the new nutrition care model during the study period. Researchers will compare outcomes before and after the new model is introduced.
Age 18 years or older
Admitted to a participating medical ward during the study period
First eligible admission during the study period
Age 18 years or older
Terminally ill patients with short expected survival
Patients admitted to an isolation room at the time of recruitment
Parallel
Dietitian-driven nutritional care model
BehavioralClinical dietitians are integrated into the ward team and assume primary responsibility for systematic nutritional risk screening, nutritional assessment, nutritional care planning, follow-up, and nutritional treatment. Dietitians identify patients requiring nutritional care without waiting for referral and collaborate with nursing staff and other clinicians to provide coordinated nutritional care during hospital admission.
Current practice nutritional care
Other interventionNutritional care delivered according to existing ward procedures, with nursing staff primarily responsible for nutritional risk screening and nutritional care planning and clinical dietitians involved following referral or consultation.
Length of hospital stay
Length of hospital stay, defined as the time from hospital admission to hospital discharge. Length of stay will be calculated in hours from electronic health record time stamps and expressed in days (hours/24). Assessed using routinely collected hospital data from all eligible patients admitted to participating wards during the study period.
Hospital re-admissions
Number of hospital readmissions after discharge from the index admission, assessed using routinely collected hospital data from all eligible patients admitted to participating wards during the study period.
Days alive and out of hospital
Days alive and out of hospital after index admission. Assessed using routinely collected hospital data from all eligible patients admitted to participating wards during the study period.
Mortality
Assessed using routinely collected hospital data from all eligible patients admitted to participating wards during the study period.
Daily energy intake
Energy intake (kJ/day) expressed as a percentage of estimated energy requirements, assessed in the prospectively recruited cohort of approximately 216 enrolled participants. Energy intake will be estimated using a 24-hour dietary recall conducted as a structured interview with the participant, supported by data from the hospital electronic meal ordering system and the electronic administration records for enteral and parenteral nutrition.
Daily protein intake
Protein intake (g/day) expressed as a percentage of estimated protein requirements, assessed in the prospectively recruited cohort of approximately 216 enrolled participants. Protein intake will be estimated using a 24-hour dietary recall conducted as a structured interview with the participant, supported by data from the hospital electronic meal ordering system and the electronic administration records for enteral and parenteral nutrition.
Click on the lead sponsor to view all of their trials.
Gødstrup Hospital
Lead sponsor
The Danish Dietetic Association
Collaborator
NIDO Research Foundation
Collaborator
Health Research Foundation of Central Denmark Region
Collaborator
