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Malnutrition Screening, Assessment and Diagnosis Following the Implementation of the Integrated Nutrition Pathway for Acute Care (INPAC): An Observational Study

ABSTRACT

Aims

Malnutrition is a prevalent and underdiagnosed medical issue in Canadian hospitals. Early detection is crucial for promoting better patient and healthcare-related outcomes. After implementing the Integrated Nutrition Pathway for Acute Care (INPAC) in a Canadian hospital in 2016, we described and compared malnutrition screening, assessment and diagnosis practices in 2017 and 2019 (post-implementation) for hospitalised patients.

Methods

Retrospective patient chart audits were conducted in nine acute care units that incorporated malnutrition screening in their electronic admission questionnaire in 2016. Malnutrition screening, assessment and diagnosis practices post-implementation (2017 and 2019) were documented using descriptive statistics, and screening and assessment practices were compared between 2017 and 2019 using chi-square tests.

Results

Between 2017 and 2019, malnutrition screening increased significantly (57.2% vs. 62.3% respectively, p < 0.001), while malnutrition assessment decreased significantly (61.3% vs. 50.8% respectively, p =  0.007). Dietitians established nutritional diagnosis more frequently in 2019 (n = 106, 86.9%) compared to 2017 (n = 75, 47.5%), with ‘malnutrition’ being the most used nutritional diagnosis in both years.

Conclusions

Although malnutrition screening and diagnosis practices have increased, further improvements are needed to identify all malnourished patients. Relying on dietetic technicians appears to be an essential component in the screening process. Providing ongoing education to other health professionals involved in the INPAC process, such as nursing staff and dietitians, may help optimise malnutrition screening and assessment, thereby reaching the recommended targets.

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Posted in: Journal Article Abstracts on 06/27/2026 | Link to this post on IFP |
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