La malnutrizione energetico-proteica nel paziente anziano ricoverato in un’unità operativa di medicina : il contributo infermieristico nella valutazione nutrizionale e nella gestione del pasto ospedaliero

Introduction. Various data assess the epidemiologic importance of the hospital Protein-Energy Malnutrition (P.E.M.) and give evidence of a strong involvement of the hospitalized elderly and specifically of those in the medicine units. The literature in this field shows a direct association between hospital P.E.M. and increased morbidity and mortality, other than a general worse prognosis thus determining prolonged hospitalization and increased healthcare cost. The importance of this issue also led the European Community and the National Health Ministry to create recommendations and to put forward initiatives to reduce the phenomenon. Main issue. Epidemiological data and the effects on patients' health caused by P.EM., which affect particularly patients in medical wards, lead to investigate the nurses' contribution in the nutritional assessment and in the mealtime management. Conclusions. Our literature review points a kind of a difficulty in translating the theoretical interest related to prevention and treatment of intra hospital P.E.M., into an action which will involve adequate nutritional care towards aged patients in the medical unit. As regards the contribution of nurses, particularly important are the nutritional screening into general assessment and the mealtime management. In this field the literature highlights various criticalities, also concerning nursing related to the clinical practice and the management of the nutritional care (lack of flexibility during meals; lack of knowledge about the nutritional care of patients; lack of clear distribution of responsibilities and tasks about nutritional care; considering nutrition a subordinate part of the care). There is a need for further research in this direction.