Optimal Nutritional Care for All Resources
Aim: To Create a platform for sharing existing good practice
Welcome to the Optimal Nutritional Care for All Resources. .
These pages aim to provide information and signposting for individuals and countries looking to develop nutritional policy by providing definitions, evidence and good practice examples. These can be used to frame National Nutrition Policy, create a case for change and demonstrate the impact of good nutritional policy.
The Resources are a compilation of information from our research and our partner/member organisations (ESPEN, BAPEN, EUGMS, EFAD and patient organisations). We have also included links to sites from other expert organisations (e.g. BAPEN) which have been approved by our members. We aim to review and update these pages on a six monthly basis and would welcome feedback and contributions from users.
We hope you will find the following information useful. We’d love to hear what you think.
Please note: Whilst every attempt has been made to ensure these links are up to date, websites are constantly changing. ENHA takes no responsibility for the content of the links provided in the Resources. Note: the term malnutrition is used to mean undernutrition. Both these terms are used regularly in the literature in this way.
Definitions and glossary of terms
ENHA has produced a glossary of commonly used terms which can be accessed here
ENHA uses the following definition of malnutrition (undernutrition), which has been agreed by its members.
‘Malnutrition, defined as an imbalance of energy, protein, and other nutrients that causes measurable adverse effects on tissue and body form and function as well as clinical outcomes. Malnutrition is most often used to mean undernutrition.’
Alternative definitions from useful sources
Malnutrition is a state of nutrition in which a deficiency or excess (or imbalance) of energy, protein and other nutrients causes measurable adverse effects on tissue / body form (body shape, size and composition) and function and clinical outcome. The term malnutrition does include obesity, but in this context undernutrition is the focus.
NICE guidance (UK)
Malnutrition is a state in which a deficiency of nutrients such as energy, protein, vitamins and minerals causes measurable adverse effects on body composition, function or clinical outcome. Malnutrition is both a cause and a consequence of ill health. It is common and increases a patient's vulnerability to disease
Building the Case for Change
Cost of malnutrition
ENHA have produced a simple first stage ‘costing analysis’. This provides a template for a basic calculation of the approximate costs that can be attributed to increased length of hospital stay resulting from malnutrition. It can be applied on a national level and may provide a starting point for further analysis.
Financial benefits of screening/nutritional intervention
Key Performance Indicators
National websites showcasing nutrition policies/plans
Netherlands – Fight Malnutrition (Dutch Malnutrition Steering Group)
Ireland – Call to Action Dec 2013
Stakeholder groups with an interest in nutrition
ENHA believes that systematic, routine screening of at risk groups is key in preventing malnutrition, particularly among older people.
Validated Screening Tools
ESPEN recognises the tools below for use in screening.
Mini Nutritional Assessment: Short Form (MNA-SF)
Nutrition Risk Screening
Malnutrition Universal Screening Tool (MUST)
MUST is also available in French, German, Italian, Portuguese and Spanish
For nutrition standards, position papers for professional and standards of care.
EFAD – European Federation of the Associations of Dietitians - Position paper on the Role of the Dietitian in the Prevention and Management of Malnutrition in Adults
UK – National Institute of Health and Clinical Excellence – Guidance on Nutrition Support
UK – National Association of Care Caterers/Hospital Caterers Association - 10 key characteristics for good nutritional care
Managing Adult Malnutrition in the Community – UK
Education and Training
Training for geriatricians
EUGMS – European Union Geriatric Medicine Society
Developed to educate physicians and other health care providers on all nutritional aspects in the care of older people.
ESPEN - European Society for Clinical Nutrition and Metabolism
ESPEN Life Long Learning (LLL) Programme in Clinical Nutrition and Metabolism
Based on an Educational curriculum offering 120 training modules (100 are already available on-line) created and peer reviewed by recognized European experts. Accredited by Union Européenne des Médecins Spécialistes. Aimed at Medical Doctors and Health Specialists, modules are freely accessible on-line after registration
Training for nurses and care staff
BAPEN – British Association for Parenteral and Enteral Nutrition
BAPEN e-learning modules for Doctors in training
Three modules available:
- Disease related malnutrition
- Nutrition support – methods and monitoring
- Nutrition support – ethical and legal issues
MUST training from BAPEN
Available for those working in hospitals, care homes and primary care.
Prevention, public awareness
UK – Guardian Newspaper – In focus – How do we tackle Malnutrition in the UK?