Addressing Malnutrition in the Hospital: The Physician Nutrition Evaluation

Appropriate nutrition support therapy in critically ill patients may positively affect patient outcomes. In this module, you will learn current standards of care for managing critically ill patients with moderate to severe nutritional risk.

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  • Michael Rothkopf, MD, Sidney Kimmel Medical College
  • Stephen McClave, MD, University of Louisville School of Medicine
  • Robert Martindale, MD, PhD, Oregon Health and Science University
  • Ryan Hurt, MD, PhD, Mayo Clinic

Malnutrition is a common condition, affecting up to 67% of hospitalized adults in the United States.  It is associated with increased morbidity and mortality, longer hospital stays, and higher readmission rates.  Detecting and treating malnutrition has been shown to improve patient outcomes and reduce healthcare costs.

This module reviews the fundamentals of the physician nutrition evaluation and the management of malnutrition.

Learning Objectives At the end of this activity, learners will be able to:

  • Identify the clinical issues involved with the physician nutritional evaluation, including determination of nutritional risk, assessment of nutritional status, and analysis of body composition;
  • Calculate energy and protein needs and assess risk of refeeding syndrome;
  • Describe which parameters should be monitored as nutritional therapy is initiated;
  • Identify the limited value of certain traditional surrogate markers of nutritional status and adequacy of nutritional therapy.

To receive course credit, complete the interactive case study; review the clinical guidelines, references and resources; and take the Physician Nutrition Evaluation Quiz.

Course Outline

  • Case Study
  • Key Clinical Guidelines
  • Tools to Diagnose Malnutrition & Nutritional Risk
  • How to Use the GLIM Tool to Diagnose Malnutrition
  • What to Look For on H&P to Evaluate Nutritional Status
  • Proper ICD-10 Diagnostic Codes for Malnutrition
  • How to Measure Body Composition
  • How to Define Risk of Refeeding Syndrome
  • The Steps to Avoid Refeeding Syndrome
  • Symptoms and Physical Findings Indicating Nutritional Deficiencies
  • GAME:  Match Physical Findings/Symptoms with the Deficiencies
  • References and Resources
  • Physician Nutrition Evaluation Quiz

Credit Information

Certified for 1 AMA PRA Category 1 Credit™ Jointly provided by Postgraduate Institute for Medicine and American Society for Nutrition. This activity is supported by an independent educational grant from Abbott Nutrition Health Institute.

Additional Details

Duration of course : 60 mins. Certificate of Completion Knowledge Check Intended Audience: Practicing physicians; residents; fellows; nurse practitioners; physician assistants; clinical researchers For optimal viewing of figures and tables, view this module on your desk/laptop computer or tablet.