7.11
Nutrition Day, ook in Nederland!
Cora Jonkers
AMC, NESPEN, Stuurgroep Ondervoeding (nationale coördinator Nutrition Day)
Eva Leistra
VUmc, Stuurgroep Ondervoeding
an initiative to improve healthcare
supported by
Nutrition Day
• Initiatief Michael Hiesmayer, intensivist
Wenen
• Plan neergelegd bij ESPEN
• Sinds 2006 jaarlijkse meting
• 3e donderdag in Januari
1e donderdag
November
• Start op verpleegafdelingen, door naar IC en
verpleeg / verzorgingshuizen
© nutritionDay 2010
supported by
Doel
• Doel
–
–
–
–
'Awareness' ondervoeding verhogen
Barrières verlagen
Kennis vergroten
Vergelijking mogelijk maken tussen individuele
afdelingen met nationale en internationale
referentie groepen
© nutritionDay 2010
supported by
Methode
• Methode
–
–
–
–
–
One day cross-sectional audit
Follow-up na 30 dagen
Informatie van 'caregiver' en patiënten
Uitkomst evaluatie per ziekenhuis
Unit report per deelnemende afdeling (voor
vergelijking met andere afdelingen met dit
specialisme)
– Vergelijking landelijk
© nutritionDay 2010
supported by
Wereldwijde deelname
2006/2007/2008/2009/2010
•
•
•
•
30 talen
40 landen
1249 units/wards
104657 patiënten
+ VS
+ Brazilië
+ Japan
+ Australië
© nutritionDay
+ Nieuw
Zeeland2010
supported by
Formulieren
© nutritionDay 2010
supported by
© nutritionDay 2010
supported by
© nutritionDay 2010
supported by
© nutritionDay 2010
supported by
© nutritionDay 2010
supported by
Nederlandse resultaten 2010
© nutritionDay 2010
supported by
January 21st 2010
November 4th 2010
18982 pt
© nutritionDay 2010
supported by
nutritionDay 2010 / Participation in your country
Specialities of participating units
Others
Ear Nose Throat (ENT)
Nephrology
Long-term-care
Gynecology
Neurosurgery
Trauma
Pediatrics
Cardiothoracic surgery
Psychiatry
Geriatrics
Infectious diseases
Cardiology
Oncology and Radiotherapy
Orthopedic surgery
Neurology
Gastroenterology and hepatology
General surgery
General internal medicine
0
1
2
3
4
17 Units
© nutritionDay 2010
supported by
5
6
7
nutritionDay 2010 / Resources
Unit Size & unit manpower
Patients / nurse
Patients / nurse
0%
6% 2%
24%
29%
20%
76%
43%
2
4
6
8
2
>8
Your country
© nutritionDay 2010
4
6
8
>8
Worldwide
supported by
nutritionDay 2010 / Structures
Nutrition team & guidelines
Is someone interested in Nutrition
Support in your unit?
6%
Is someone interested in Nutrition
Support in your unit?
30%
70%
94%
NO
YES
NO
Your country
© nutritionDay 2010
YES
Worldwide
supported by
nutritionDay 2010 / Demographics (worldwide vs your country)
Age categories in years
Age distribution
missing
>100
100
90
80
70
60
50
40
30
20
10
worldwide
your country
0
5
10
15
20
25
% patients
© nutritionDay 2010
supported by
30
nutritionDay 2010
Body Mass Index
Worldwide:
•BMI (Med) 24.4
14.6%
•BMI  20
14.7%
•BMI > 30
0.20
0.18
proportion
0.16
0.14
0.12
0.10
0.08
0.06
0.04
0.00
10
12
14
16
18
20
22
24
26
28
30
32
34
36
38
40
42
44
46
48
50
0.02
BM I
© nutritionDay 2010
Your country:
•BMI (Med) 24.8
6.9%
•BMI  20
13.5%
•BMI > 30
supported by
nutritionDay 2010 / Worldwide vs your country
Weight loss before admission
missing
I don’t know
worldwide
your country
No, I’ve gained weight
No
Yes
0
10
20
30
40
% patients
283/362 patients (78%) answered this question in your country, worldwide (83%)
© nutritionDay 2010
supported by
nutritionDay 2010 / Worldwide vs your country
Last weeks eating
missing
quarter less
worldwide
half less
your country
bit less
normal
0
10
20
30
40
50
% patients
283/362 patients (78%) answered this question in your country, worldwide (83%)
© nutritionDay 2010
supported by
nutritionDay 2010 / Nutrition Care (worldwide vs your country)
Nutrition given to patients
missing
Others
Protein supplement
EN+PN
worldwide
your country
PN
EN
Special diet
Hospital food
0
10
20
30
40
50
% patients
© nutritionDay 2010
supported by
60
70
nutritionDay 2010 / Nutrition (worldwide vs your country)
Lunch eaten on nutritionDay
missing
nothing not allowed
nothing allowed
worldwide
your country
quarter
half
all
0
10
20
30
40
% patients
252/362 patients (70%) answered this question in your country, worldwide (81%)
© nutritionDay 2010
supported by
% patients
Lunch eaten on
nutritionDay
worldwide
40
35
30
25
20
15
10
5
0
12
ha
all
ha
lf
10
% patients
Death in hospital
before 30 days
following ND
worldwide
all
8
r
ed
ed
i ng
r te
s
w
w
a
s
o
o
qu
all
mi
al l
t
g
o
n
thi
gn
o
n
i
n
th
no
6
4
2
0
© nutritionDay 2010
lf
d
d
er
we
we
ar t
o
o
u
l
l
l
l
q
ta
ga
o
n
i
n
th
ng
i
no
h
t
no
supported by
i ng
ss
i
m
30
% patients
Lunch eaten on
nutritionDay
Your country
25
20
15
10
5
0
all
ha
lf
5
% patients
Death in hospital
before 30 days
following ND
Your country
6
q
r te
ua
n
4
r
in
oth
ga
no
we
llo
d
n
ng
i
h
t
ot
ed
w
o
al l
i ng
s
s
mi
ed
w
o
al l
i ng
s
s
mi
3
2
1
0
all
ha
lf
q
r te
ua
n
© nutritionDay 2010
supported by
r
in
oth
ga
no
we
llo
d
n
ng
i
h
t
ot
nutritionDay 2010 / Outcome (Worldwide vs your country)
Hospital discharge?
readmitted
missing
others
death
worldwide
discharge home
your country
rehabilitation
transfered to long-term-care
transfered to other hospital
still in hospital
0
10
20
30
40
50
% patients
© nutritionDay 2010
supported by
60
70
80
Publicaties
© nutritionDay 2010
supported by
© nutritionDay 2010
supported by
© nutritionDay 2010
supported by
Nutrition Day in nursing homes
© nutritionDay 2010
supported by
ND & Prestatie-indicator ondervoeding
• Screening (continue meting)
– Gaat steeds beter!!!
• Behandeling (4 puntmetingen PI ondervoeding)
– ± 50% vd patiënten halen het eiwitdoel (1.2-1.5
g/kg) op dag 4 niet
 Nutrition Day aangrijpen om oorzaken te zoeken
© nutritionDay 2010
supported by
Combineer Nutrition Day met de PI !!
• Nutrition Day
– Jaarlijks terugkerende meting begin november
– Dit jaar: 10 november 2011(mag natuurlijk ook een andere
dag daar in de buurt!!)
• PI behandeling ondervoeding
– 4 metingen per jaar (4e kwartaal)
 Mogelijkheid tot inschakelen studenten
(contact zoeken met opleidingen!)
© nutritionDay 2010
supported by
Plan van aanpak
© nutritionDay 2010
supported by
Wat levert het op?
•
•
•
•
Inzicht in stand van (voedings)zaken afdeling
Bewustwording verschillen tussen afdelingen
Referentie andere afdelingen / ZH / landen
Gebruik internationale database voor
verwerken gegevens
• Genereren gegevens te gebruiken in de strijd
tegen ondervoeding!
© nutritionDay 2010
supported by
Nutrition Day: 10 november 2011
Meer informatie over Nutrition Day op:
http://www.nutritionday.org
email:office@nutritionday.org
www.stuurgroepondervoeding.nl
Cora Jonkers (contactpersoon Nederland):
c.f.jonkers@amc.uva.nl
© nutritionDay 2010
supported by
Maak werk van je idealen!
© nutritionDay 2010
supported by