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St. Joseph's Health Centre Toronto

Reducing pressure injuries and length of stay — with food

Sharon Chandra, dietitian, performs an SGA on a patient

One of the most important medications you may take in hospital is food. Eating properly helps you recover faster, reduces your chances of developing additional complications and helps ensure you don’t have to come back again after you’ve gone home. A new process at St. Joseph’s is making it easier for staff to have important conversations about nutrition with patients and help them get the nutrients they need.

When a patient is admitted to the hospital, they’re asked questions about their diet – have they recently lost weight without trying and are they eating less than usual? If the patient answers yes to both, a dietitian follows up with them to conduct a subjective global assessment (SGA).

“It’s a mix of questions and a physical exam,” said Antonia Morganti, registered dietitian. “We’ll look at factors that may be impacting their ability to eat and also show them if they have signs of muscle wasting or fat loss so they can understand that their ability to recover is reduced when they’re not eating properly.”

The Canadian Malnutrition Task Force highlights that almost half of patients admitted to hospital are malnourished, which can contribute to a range of issues including increased risk for pressure injuries, an increased length of stay and general decrease in stamina and health. The SGA is a tool that can be used to identify potential malnutrition so the care team can help intervene. Strategies for supporting malnourished patients can include changing their diet, referring them to a speech-language pathologist if there are functional issues with eating, or adding additional protein to the food they are consuming.

“We work with patients to get consent before beginning any of these measures because it’s critical they appreciate how significant food is to their health,” Morganti said. “I always want people to understand that it’s not OK that they’re not eating well and that we’ll do everything we can to work with them to change that.

“Our goal is to get people home healthy as quickly as possible,” she said. “We’re really focused on working with our patients and families to help make nutrition a key part of their stay so that they’re strong enough to recover and then know how to maintain a healthy diet when they’re back in their own homes.

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