FIGHT AGAINST MALNUTRITION

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.