Reducing Inpatient Malnutrition Through Nurse Education Essay

Length: 4 pages Sources: 3 Subject: Healthcare Type: Essay Paper: #34730278 Related Topics: Medicare Fraud, Experiential Learning, Wound Care, Nursing Shortage

Excerpt from Essay :

Malnutrition Education Intervention Nursing Education

Malnutrition Education Intervention for Mercy Medical Center Redding

Malnutrition Education Intervention for Mercy Medical Center Redding

The Mercy Medical Center in Redding, California, a 267-bed non-profit level II trauma center within the Dignity Health healthcare system (Mercy Medical Center Redding, 2013), appears to be unaware of a growing concern about the impact of inpatient malnutrition on health care outcomes. A word search on Mercy's website using the word 'malnutrition' retrieved only one result and this document discusses malnutrition in a patient resource guide ("Search," 2014). The lack of apparent concern about inpatient malnutrition among hospital clinicians and administrators is not atypical of many U.S. hospitals, but a few have begun to take this issue seriously (Vesely, 2014). Close to one-third of all patients admitted to hospitals in the U.S. are estimated to suffer from malnutrition (Vesely, 2014, p. 32), whether due to unexplained weight loss, loss of appetite, or drug-induced dietary changes (Sheperd, 2009), but only 3% are ever diagnosed with this condition (Corkins et al., 2014). This prevalence estimate also applies to patients residing in hospitals, because malnutrition often goes undetected, even when it has an iatrogenic etiology (Bavelaar et al., 2008).

The Alliance to Advance Patient Nutrition (AAPN) represents the collaborative efforts of Abbott Nutrition, the Academy of Medical-Surgical Nurses, the Academy of Nutrition and Dietetics, and the Society of Hospital Medicine (AAPN, 2013). The goal of the AAPN is to improve patient nutrition practices and therefore health care outcomes. If malnutrition is left untreated the risk of complications, delayed wound healing, infections, longer hospital stays, readmissions, and mortality increase significantly (Bavelaar et al., 2008). In the current climate of healthcare cost awareness, malnutrition cannot be ignored. The main categories of malnutrition are kwashiorkor (ICD-9-CM 260), malnutrition of a moderate degree (ICD-9-CM 262), and marasmus (ICD-9-CM 261), with the first two representing protein intake insufficiency and the latter also involving insufficient carbohydrate ingestion (Sheperd, 2009). All are eligible for significant Medicare reimbursement (Bryant, 2012).

Frame Factors

The City of Redding is located at the northern-most end of California's Central Valley and is home to approximately 90,000 citizens. An estimated 22.8 and 16.4% of Redding residents are under 18-years of age or 65 and older, respectively (U.S. Census Bureau, 2014). The median household income is about 30% below the California average, which is consistent with a greater proportion of the population living below the federal poverty line. In 2002, close to 18% of school children within California's Central Valley were eligible for welfare assistance and over 50% were receiving subsidized lunches, although children living in the North Valley fared slightly better (Danenberg, Jepsen, & Cerdan, 2002, p. v, vii). This is a solidly blue collar town, with more residents completing high school and not attending college compared to the rest of the state (U.S. Census Bureaur, 2014). Redding is a relatively homogenous community ethnically, with over 80% of the population sef-identifying as Caucasian. The next biggest ethnic group is Hispanics, which represents only 8.7% compared to 37.6% state-wide.

The academic environment in Redding is limited, with only two academic institutions offering nursing degrees and none providing graduate level coursework (Board of Registered Nursing, 2013). Accordingly, Shasta County where Redding is located has been designated a registered nurse (RN) shortage area by the State of California (OSHPD Healthcare Workforce Development Division, 2011). Approximately 70% of voters supported the Republican presidential candidate in the last five general elections, so it is a politically conservative city (, 2013). In 2011, the Shasta Regional Medical Center owned by Prime Healthcare Services captured the attention of a watchdog group because of a surge in kwashiorkor Medicare claims (Williams, Jewett, & Doig, 2011). The allegations of Medicare fraud could make it difficult for other local hospitals to implement a malnutrition screening program if it results in significantly higher prevalence rates; however, this should not be a significant barrier, only a consideration.

The mission statement of Mercy Redding emphasizes meeting the healthcare needs of the poor and disenfranchised (Mercy Medical Center Redding, 2014). Accordingly, Mercy Redding is committed to engaging with the community and making a positive contribution. For example, during fiscal year 2013 Mercy Redding contributed over $43 thousand dollars to the Good News Rescue Mission to support heart health programs for the homeless and very low income residents. Given Mercy Redding's focus on serving the poorest residents of the city it seems reasonable to assume that a higher percentage of its patients would be suffering from malnutrition. Of the five core values Mercy Redding identifies with, stewardship and excellence seem most relevant...


Stewardship is defined as promoting healing and wholeness, while excellence means exceeding expectations through teamwork and innovation. Despite these important values, however, Mercy Redding does not include evidence-based practice in its vision. On the positive side, over 98% of nursing staff are RNs (California Department of Health Care Services, 2012). Inpatient Malnutrition Education Intervention

Implementing effective malnutrition screening requires modification of nursing workflow processes. Accordingly, an education intervention for malnutrition screening would probably be most effective if it was based on experiential learning theory as outlined by David Kolb in 1984 (Lisko & O'Dell, 2010). According to Kolb, learning occurs when the experience is transformed. Implementation of a nursing education intervention to identify patients suffering from malnutrition would be most effective, therefore, if it took place during patient admissions, nursing rounds, patient handoffs, and patient discharges. The person best situated to implement and enforce malnutrition screening, treatment, and follow-ups is the charge nurse. Based on best practice recommendations the only costs associated with implementing this education intervention would by the extra hours required of the charge nurse, since any costs associated with treatment would be reimbursed. Two weeks of full-time equivalent (FTE) hours for the development of an education intervention, along with six hours per week for the next six months, should be sufficient to implement malnutrition screening education into the relevant nursing workflow tasks. At Mercy Redding the cost of an average hour of work by an RN is about $45 (California Department of Health Care Services, 2012), so the budget for the intervention would be [80 hrs + (26 x 6 hrs)] x $45 = $10,620. See Appendix for the intervention outcome evaluation tool.

Cite this Document:

"Reducing Inpatient Malnutrition Through Nurse Education" (2014, July 27) Retrieved June 1, 2023, from

"Reducing Inpatient Malnutrition Through Nurse Education" 27 July 2014. Web.1 June. 2023. <>

"Reducing Inpatient Malnutrition Through Nurse Education", 27 July 2014, Accessed.1 June. 2023,

Related Documents
Palliative Care
Words: 21397 Length: 70 Pages Topic: Healthcare Paper #: 29297573

Hisory of Palliatve Care Palliative Care Palliative Care Methods Palliative care entails assisting patients get through pain caused by different diseases. The patient may be ailing from any diseases, be it curable or untreatable. Even patient who are sick and almost passing away will need this care. Palliative care has characteristics that differentiate it to hospice care. The key role for palliative care is to help in improving the existence of someone and

Healthcare in Saudi Arabia Project
Words: 13191 Length: 40 Pages Topic: History - Israel Paper #: 81599113

Lack of accountability, transparency and integrity, ineffectiveness, inefficiency and unresponsiveness to human development remain problematic (UNDP). Poverty remains endemic in most Gulf States with health care and opportunities for quality education poor or unavailable, degraded habitats including urban pollution and poor soil conditions from inappropriate farming practices. Social safety nets are also entirely inadequate and all form part of the nexus of poverty that is widely prevalent in Gulf countries.

Consultant Pharmacists Impact on the Treatment of Hypercholesterolemia...
Words: 32313 Length: 116 Pages Topic: Pharmacy Paper #: 32119635

Consultant Pharmacists Impact on the Treatment of Hypercholesterolemia What is Cholesterol, and Why is it of Concern? Guidelines for Treating Hypercholesterolemia Management of Hypercholesterolemia Management of Hypercholesterolemia By Different Health Care Workers. Practical Management of Hypercholesterolemia Community Pharmacists and the Management of Hypercholesterolemia Economic Impact of Pharmacists' Treatment of Hypercholesterolemia This paper will look at the impact of consultant pharmacists on the treatment of hypercholesterolemia by physicians. Pharmacists have now assumed responsibilities outside the dispensing counter and have

Elder Care the Baby Generation
Words: 5100 Length: 15 Pages Topic: Family and Marriage Paper #: 76486184

Ruth E. Mathias and a.E. Benjamin (2003) report that social workers are becoming increasingly concerned about elder abuse in long-term care settings (p. 174). A study conducted by these social scientists/authors, reveals that Medicaid related agency care demonstrates no harmful or increase in the abuse suffered by elderly people receiving care through private agencies, but that there is little social worker oversight, and because of that, reports and information