Study to Compare Strategies to Improve Detection of Nutritional Disorders in Hospitalized Adults (Compass Project)

Study Overview
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Brief Summary
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The prevalence of malnutrition in hospital is very high (30 percent) with major consequences in terms of morbidity and mortality, generating significant health care costs. The positive impact of its support is demonstrated. The HAS (French High Sanitary Authority) recommends a screening of all adult hospitalized in the first 48 hours, with no consensus regarding the organization of screening within care services. Various strategies have been implemented. Although this screening is part of the nursing role, old and recent studies show that it is not done systematically and nutritional disorders are largely under-diagnosed and therefore untreated. The investigators assume that an organization of screening for eating disorders, based on a caregiver dedicated to this activity, improves the indicator IPAQSS (Indicateurs Pour l'Amélioration de la Qualité et de la Sécurité des Soins) which is an indicator for the improvement of the quality and security of care) Screening indicator of nutritional disorders Level 3, compared to an organization classic involving the care teams in their entirety. This indicator reflects the care system performance. In this study, patients will have no intervention. Only the organization of the care staff will be adapted but with no changes on the care of patients?

Detailed Description
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Undernutrition in the hospital is a public health issue. The impacts of this malnutrition are known , with consequences clearly established on the morbidity, mortality and quality of life. Undernutrition is an independent risk factor for mortality (5). In terms of morbidity, the most frequently reported consequences are infections, postoperative complications (delayed healing, in particular nosocomial infections, risk of pressure ulcers) and pejorative impact on the prognosis of chronic diseases such as respiratory failure , heart and kidney. Malnutrition therefore affects the length of hospital stays and the burden of care. Many studies have shown the positive impact of the medical care of malnutrition on morbidity and mortality, whether intervention studies in general hospital population or in specific pathologies. But there is no systematic screening strategy undernutrition implementation in hospitals. The investigators assume that the organization of screening for eating disorders based on a caregiver specifically dedicated to this activity, improves the indicator IPAQSS Screening indicator of nutritional disorders level 3 compared with a classic organization shared between different actors of care. This indicator reflects the care system performance This organization must advance quickly and significantly the number of patients evaluated nutritionally and help reach a level of completeness close to 100%.

Official Title
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Study to Compare Strategies to Improve Detection of Nutritional Disorders in Hospitalized Adults (Compass Project)

Conditions
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Nutritional Disorder

Intervention / Treatment
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* Other: Caregiver dedicated
* Other: Classic strategy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients admitted in medicine-surgery-obstetrics department Patient over 18 years Exclusion Criteria: Patient hospitalized less than 48 hours Patients under 18 years

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Neuroscience pole<br>Patient hospitalized in the department of medicine-surgery-obstetric of the neuroscience pole department | Other: Caregiver dedicated<br>* Organization of nutrition screening with the help of a caregiver<br>|
| Respiratory tracts pole<br>Patient hospitalized in the department of medicine-surgery-obstetric of the respiratory tracts pole department | Other: Classic strategy<br>* Classic organization with the training of the department team<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of patients responding at the level 3 of IPAQSS criterion |  | Before the surgery and 6 months after the surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of patients responding at the level 2 of IPAQSS criterion |  | Before the surgery and 6 months after the surgery | 
| Change of the cost-efficiency | The cost of hospitalization between the 2 arms will be compared | Before the surgery and 6 months after the surgery | 
| Change of patients responding at the level 3 and level 2 of IPAQSS criterion |  | 15 months after the surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Screening for nutritional disorder, Comparison of two organizations, Indicator IPAQSS