{
    "abstract": "The Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition (AND/ASPEN) published malnutrition guidelines in 2014. In 2015, our institution implemented a quality improvement project focused on malnutrition identification with the goal to improve the diagnosis of malnutrition in hospitalized children.\nOur project included three approaches: education, nutrition assessment, and documentation initiatives. Education initiatives focused on physicians at all levels of training. Nutrition screening was completed on all patients admitted to our institution. Registered dietitians (RDs) conducted nutrition assessments and identified and documented malnutrition based on AND/ASPEN guidelines. Documentation initiatives included development of automatic text and template changes to allow import of RD-assigned malnutrition diagnosis into physician documentation. We met with members of our clinical documentation integrity team regularly to review the results of these initiatives starting in 2016.\nThe total diagnosed cases of malnutrition increased from 208 cases in 2016 at the start of our monitoring to >800 cases per year in 2020-2022. Unspecified (no severity assigned) protein calorie malnutrition as a percentage of total malnutrition diagnoses decreased from 36.9% in 2016 to <10% since 2018. Children with severe malnutrition have remained the largest portion of children with a malnutrition diagnosis, with >40% of children with malnutrition diagnosed with severe malnutrition.\nOur education and documentation initiatives have led to both improved diagnosis of malnutrition and accurate identification and documentation of malnutrition severity. These initiatives could be utilized to improve malnutrition diagnosis and documentation at other institutions caring for hospitalized children.",
    "authors": [
        {
            "affiliation": "Division of Pediatric Gastroenterology, School of Medicine, Indiana University, Indianapolis, Indiana, USA.",
            "firstname": "Annemarie",
            "initials": "A",
            "lastname": "Rompca"
        },
        {
            "affiliation": "Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, USA.",
            "firstname": "Anne",
            "initials": "A",
            "lastname": "McCallister"
        },
        {
            "affiliation": "Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, USA.",
            "firstname": "Wendy",
            "initials": "W",
            "lastname": "Cruse"
        },
        {
            "affiliation": "Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, USA.\nDivision of Pediatric Hospital Medicine, School of Medicine, Indiana University, Indianapolis, Indiana, USA.",
            "firstname": "Emily C",
            "initials": "EC",
            "lastname": "Webber"
        },
        {
            "affiliation": "Division of Pediatric Gastroenterology, School of Medicine, Indiana University, Indianapolis, Indiana, USA.\nRiley Hospital for Children at Indiana University Health, Indianapolis, Indiana, USA.",
            "firstname": "Charles",
            "initials": "C",
            "lastname": "Vanderpool"
        }
    ],
    "conclusions": "Our education and documentation initiatives have led to both improved diagnosis of malnutrition and accurate identification and documentation of malnutrition severity. These initiatives could be utilized to improve malnutrition diagnosis and documentation at other institutions caring for hospitalized children.",
    "copyrights": "\u00a9 2023 The Authors. Nutrition in Clinical Practice published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition.",
    "doi": "10.1002/ncp.11080",
    "journal": "Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition",
    "keywords": [
        "hospitalized child",
        "malnutrition",
        "nutrition assessment",
        "quality improvement"
    ],
    "methods": null,
    "publication_date": "2023-10-11",
    "pubmed_id": "37817534",
    "results": "The total diagnosed cases of malnutrition increased from 208 cases in 2016 at the start of our monitoring to >800 cases per year in 2020-2022. Unspecified (no severity assigned) protein calorie malnutrition as a percentage of total malnutrition diagnoses decreased from 36.9% in 2016 to <10% since 2018. Children with severe malnutrition have remained the largest portion of children with a malnutrition diagnosis, with >40% of children with malnutrition diagnosed with severe malnutrition.",
    "title": "Education and documentation strategies to improve malnutrition diagnosis in hospitalized children: A quality improvement project.",
    "xml": "<Element 'PubmedArticle' at 0x788505fb7970>"
}