Data collected on NutritionDay2006 showed that disease-related malnutrition increases length of stay by 6 days and is accompanied by a fourfold increase in mortality. The president of the Ecosocial Forum Europe, former EU-commissar Franz Fischler emphasises the social dimension of the Initiative.
"NutritionDay in Europe" is a large audit which collects information by interviewing patients directly about their nutrition care while in hospital. The project was launched last year by a group of Austrian Researchers with the help of a network of national coordinators from the European Society of Clinical Nutrition and Metabolism (ESPEN). NutritionDay2007 has a target of involving more than 20000 patients as participants from 1000 units in 31 countries. Questionnaires are available in 26 languages. The aim of “NutritionDay in Europe” is to increase awareness and knowledge about the importance of nutrition status and care to recovery from illness from the viewpoint of patients, their carers and the public. The ultimate goal is to reduce the burden of illness and to decrease health care costs.
In 2006 the audit included 16.455 patients from 748 units in 25 countries. The results show the importance of nutrition care and monitoring for healthcare. Disease-related malnutrition is associated with 50% increase in length of stay in hospitals and a substantial increase in mortality.
The NutritionDay initiative in Europe is supported by several political authorities but also by the current president of the Ecosocial Forum Europe, Franz Fischler, former EU commissar for agriculture: “The “NutritionDay” initiative has established a network, intended to promote sustainable improvement in the nutrition of patients. Knowledge about all dimensions of good nutrition care – including the social dimension - will underpin this goal by attracting participation from a large number of patients and units."
„NutritionDay in Europe“ is the first project where patients and carers have been interviewed with standardised questionnaires, in their mother tongue, throughout Europe. In 2007, for the first time, nursing homes and intensive care units will also be able to participate.
According to Prof. Michael Hiesmayr, the coordinator of the project, from the Medical University Vienna, important preliminary information could be obtained from NutritionDay 2006:
- 47% of the „NutritionDay“ patients had been hospitalised with signs of disease-related malnutrition. Only one out of three patients eat all that they have been served (38%). One consequence is that length of stay can be increased by 6 days.
- One out of five patients ate less than a quarter of what they were offered or nothing at all. Only 11% of those eating very little indicated that they did not like the food. The majority (47%) either had no appetite or had nausea (14%). The reason for this was considered to be the illness itself or the stress of being in hospital.
- Reduced appetite is associated with increased mortality. Patients with an adequate intake had a mortality of 1,3 %: those with half normal intake 2.4% and for all those eating less than a quarter or nothing mortality was above 5%.
- Hospitalised patients with an increased body weight had a reduced mortality. This apparent advantage is largely negated by the higher risk of becoming ill. Although already suspected, this observation was confirmed by the NutritionDay population.
The problem of eating and nutrition care in hospitals was addressed in 2003 by a resolution of the Council of Europe signed by 18 countries. The intention of the NutritionDay project, which is scheduled for a minimum of 3 years, is to move the political declaration of the Council of Europe into reality.
The actual goals of the "NutritionDay in Europe" are to:
- Improve awareness and knowledge about the importance of nutritional status for enhanced recovery from illness for patients, carers and relatives as well as political and economicl decision makers
- Reduce individual suffering
- Decrease costs for the community
- Enhance learning within units resulting from repeated bench-marking
- Initiate a research project with the slogan “ Eating despite Disease”
- Emphasis the practical potential of artificial nutrition
- Increase networking between institutions and experts
The back-bone of the project is an annual data collection on one single day to audit actual nutrition care and nutrition monitoring. In addition to bench-marking it should be possible to trace changes in local practice and international trends.
Franz Fischler, from 1995 to 2004 EU commissar for agriculture and currrent president of the Ecosocial Forum Europe:
“One factor that will help this initiative to succeed is the adoption of a “bottom-up” strategy that allows patients, their carers, nurses and physicians to express their views and opinions. The resulting shared experience together with easy comparison at local and international level will help to achieve a significant improvement”.
The specific focus of interest is the individual unit which is responsible for the care and management of a defined type of patients, and which has fixed staff, a local culture and where an active group of careers share an ethos.
The data collected during NutritionDay 2006 have been analysed anonymously and all units received a report about their individual data. The participating units can then compare their data with anonymised data from other units caring for similar patients or with regional and national data.
The project is supported by the European Society for Clinical Nutrition and Metabolism (ESPEN), the Austrian Society for Clinical Nutrition (AKE), the national societies for clinical nutrition and the Medical University, Vienna.
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