FIGHT AGAINST MALNUTRITION IMPLEMENTATION OF OBLIGATORY NUTRITIONAL SCREENING AND INTRODUCTION OF NUTRITIONAL TEAMS IN

1. FIGHT AGAINST MALNUTRITION IMPLEMENTATION OF OBLIGATORY NUTRITIONAL SCREENING AND INTRODUCTION OF NUTRITIONAL TEAMS IN POLISH HOSPITALS POLISH SOCIETY FOR PARENTERAL AND ENTERAL NUTRITION (POLSPEN) Description of the problem and background of the initiative Disease-related malnutrition (undernutrition) is a critical public health concern in Europe, affecting around 20 million citizens and costing EU governments up to 120 billion Euros every year. Situation in Poland is similar to the rest of European countries: Nutrition Day study showed that almost half of patients reported some change (reduction) in food intake before admission to the hospital and every tenth patient was severly malnourished. In 30% of patients the nutritional state deteriorated during hospitalisation. Polish Society for Parenteral and Enteral Nutrition (POLSPEN) is the oldest and the largest Polish scientific society dealing with issues of nutrition and metabolism. It was founded in 1986 as a section of Polish Medical Society and transformed into separate society in 1998. It has now over 500 members recruited from physicians, nurses, pharmacists and dietitians. Since the beginning POLSPEN was the member of ESPEN. For many years POLSPEN has cooperated with Polish government and other authorities to improve the situation of Polish patients • Activities • To implement the obligatory nutritional screening in Polish hospitals • To introduce Nutritional Teams in Polish hospitals • To use Polish Presidency of EU to spread the information about malnutrition and its importance Implementation and Results Thanks to POLSPEN activities following targets were achieved: On September the 15th 2011, Polish Ministry of Health issued a regulation on malnurition. According to this regulation all Polish hospitals were obliged to: a/ assess the nutritional status of every patient (adults and children) admited to any hospital unit using SGA or NRS 2002 (a growth chart in children) b/ implement the nutrtional intervention (fully reimbursed by national insurance company) in all patients who require it c/ establish Nutritional Teams formed of at least one physician, nurse, dietitian and pharmacist. Those teams should monitor the nutritional activities in their hospital, improve its quality and increase the awareness 2. On October the 6th, 2011, rrepresentatives from the European Parliament, the Ministry of Health, the Polish Presidency of the European Union, the European Society for Parenteral & Enteral Nutrition (ESPEN), POLSPEN, ENHA, MNII, cientific and professional associations, industry, patient and health insurance groups,met in Warsaw and issue the Declaration to warn EU Governments and citizens that disease-related malnutrition is a critical public health concern.Four key areas have been identified for decision and collective action to help address the wide range of adverse effects that malnutrition can have on patients and healthcare systems. Those included: 1. Implementation of routine nutrition-risk screening across the EU 2. Increase public awareness 3. Improve reimbursement policies 4. Improve medical education The Declaration was forwarded to EU Council of Ministers by the Polish Ministry of Health and the Polish Presidency of the EU Conclusions POLSPEN activities resulted in the enormous increase of the interest in nutritional problems not among Polish physicians, nurses and hospital management, but also authorities. Moreover, Lithuania and Greece used Polish actions to force their governments to implement similar actions in their countries. Recently, Adriatic countries undertook similar actions and issued their Declaration.