Deficiencies in assessing the nutritional status of hospital patients - A revised nutritional care recommendation will improve the effectiveness of care

March 7/2023

The assessment of patients' nutritional status needs further improvement in Finland. Malnutrition increases the risk of complications and slows down recovery. Thus, it also increases the workload of nursing staff and extends treatment times.

Malnutrition is a risk for all hospital patients, but it affects in particular patients with long-term illnesses, those preparing for surgery, cancer patients and those recovering from severe infections and traumas.

The National Nutrition Council and the Finnish Institute for Health and Welfare have published a revised nutritional care recommendation. One of the objectives of the recommendation is to enhance nutritional care and guidance as a part of the patient's comprehensive care.

According to several studies, screening for the risk of malnutrition and preventing malnutrition reduce the costs of treatment.

"The patient's nutritional status and risk of malnutrition should always be assessed when they enter treatment, no matter what the reason for seeking treatment. At the moment, this happens too rarely," says Ursula Schwab, Professor of Nutritional Therapy at the University of Eastern Finland.

"Good nutrition improves a patient's quality of life. In addition, nutritional care and guidance appropriate to the specific patient's needs saves money. This is important to take into consideration in the wellbeing services counties as we face the challenge of growing costs", Schwab says.

Revised recommendation defines the quality of the food served to patients

The revised nutritional care recommendation includes minimum requirements for the nutritional quality of food served to patients. In addition, vegetarian diets have been added to the basic food selection alongside a diet containing meat.

The recommendation is intended to guide the planning and implementation of nutritional care in hospitals, care and rehabilitation institutions as well as the organisation of catering services, food procurement and competitive tendering.

"The recommendations apply to all patients, from infants to the elderly. The recommendation describes how patient nutrition should be seen to in different illnesses. For example, how do we improve the nutritional intake of a patient suffering from malnutrition, who has lost weight, and how can we improve protein intake with food or clinical nutrition supplements or what are the foods that should be served to patients who have had intestinal surgery and those who have swallowing disorders," says Schwab. 

Based on international recommendations, scientific evidence and extensive expert work

The recommendation is based on international nutritional care recommendations, evidence-based information in clinical nutrition and medicine, good treatment practices and national Current Care Guidelines.

It has been drawn up by an interprofessional expert group, which has gone through very extensive scientific literature. The recommendation’s draft was also open to the public for comments.

"The preparation of the recommendation was the most thorough work ever carried out by the National Nutrition Council for the nutrition recommendations of different population groups. It is a valuable guide for the new wellbeing services counties to use in the co-creation and quality assurance of nutritional care and hospital meals,” says Markku Tervahauta, Director General of the Finnish Institute for Health and Welfare.

“The recommendation must be implemented comprehensively in all wellbeing services counties, and it must be seen to that everyone participating in patients’ care is familiar with its content and uses it in their work.”

Additional information

Ursula Schwab
Professor, Expert Group Chairperson
University of Eastern Finland
Tel. +358 29 445 4528

Arja Lyytikäinen
Secretary General
National Nutrition Council
Tel. +358 50 409 9860