Description
In the last national census there was a demographic change with an ageing population that will compromise the sustainability of the health systems. Since malnutrition is a problem affecting a high percentage of the elderly population, in order to plan the relevant strategies, it is important to know their nutritional status. Through this project, the CHSJ will act in their own inpatient services and in health centers of influence to: increase awareness of the nutritional status of the elderly; implement the nutritional screening in primary and tertiary health care, providing software with validated instruments for that purpose; train professionals in nutrition in the elderly population by promoting healthy ageing and reducing health inequalities; and improving the nutritional status of the elderly population at risk, using an interdisciplinary approach and allowing equal access of all malnourished elderly population to the nutritional teams. The objectives of this project fall under the NSP 2012-2016 "Obtaining Health Gains" (HSG1) and under "Promoting Supportive Environments for Health throughout the Life Cycle" (HSG2) with direct and indirect intervention in the elderly population.
Summary of project results
Malnutrition has been associated with several poorer outcomes, namely increased risk of falls, infections, pressure ulcers, impaired wound healing, reduced respiratory function, longer length of hospital stay and greater mortality. Older people are at higher risk of malnutrition. For these reasons it is very important to address malnutrition by routine screening. The Qualife + Project was designed to allow São João Hospital to perform an early nutritional screening of the elderly people admitted at the hospital. It is expected that a timely identification of risk situations of malnutrition, will allow a quicker intervention, and consequently prevent or improve clinical outcomes associated with nutritional status. This project aimed to develop a software that can be used to screen malnutrition. This software was integrated in the informatics system of the hospital, and consists of a tool that compromises several questions to address nutritional status. The questions are firstly filled by the nursing team. After all the questions have been answered, a score is calculated. The score indicates if the person has an adequate nutritional status, is in risk of malnutrition or malnourished. If someone is assessed as being in risk of malnutrition or malnourished the software generates an alarm to the nutrition team, that will assess and define a nutritional intervention for the inpatient as soon as possible. 13001 patients were screened for malnutrition in the first 48h of hospital stay, of these 34.3% were at malnutrition risk (n= 4464) and 21.1% (2742) were malnourished. 5095 were assessed by the Nutrition team and 38,5% were submitted to a nutrition intervention. At the same time, it was assessed the nutritional risk of 2323 elderly patients from 2 Primary Health Care Center of Porto region. Besides the malnutrition screening, this project aimed to provide training to primary healthcare professionals. 64 primary healthcare professionals had received training in areas related with nutrition in the elderly (healthy eating, nutritional needs in the elderly, malnutrition screening tools, diabetes, dyslipidaemia, obesity). As outputs of this project we can mention the software developed and the training materials. It also should be mentioned that this project allowed the equipment of the hospital with: 40 electronic balances, 5 body composition analysis equipment, 90 computers, 11 laptops and allowed the installation of a wireless network.
Summary of bilateral results