Transcript Plenary presentation - The European Nutrition for Health Alliance

CROATIAN MEDICAL ASSOCIATION
CROATIAN SOCIETY OF CLINICAL NUTRITION
Chair: Anne de Looy
Group 1: Croatia and Poland
Croatian activities in Optimal Nutritional Care
for All
1. Where are we today?
CROATIAN SOCIETY OF CLINICAL NUTRITION, CMA
1. Education activities
a) Incorporation of clinical nutrition in study curriculum of:
•
School of Medicine
•
School of Food and Technology- Nutritionists
•
Nursing study
b) Different postgraduate courses (Medicine, Nutrition, Pharmacy)
c) Postgraduate Study of Nutrition (Medicine & Nutrition)
c)
Local LLL courses in cooperation with local MNI
d)
Congresses and Symposia
e)
Adriatic Club of Clinical Nutrition (ACCN)
ACCN Initiative following
Fight against malnutrition
Warsaw Declaration
ACCN Declaration
CROATIAN SOCIETY OF CLINICAL NUTRITION, CMA
2. National Nutrition Guidelines
•
Croatian Guidelines For Use Of Eicosapentaenoic Acid And Megestrol Acetate In
Cancer Cachexia Syndrome (2007)
•
Croatian guidelines for use of enteral nutrition in Crohn's disease (2010)
•
Internal Guidelines at University Hospital Centre Zagreb (2011)
Nutrition Guidelines for GERD and Gastritis, IBD, Hypertriglyceridemia and
•
Hypercholesterolemia
•
Croatian guidelines for treatment of diabetes mellitus type 2 (2011)
•
Chapter: Guidelines for usage of enteral nutrition DM2
•
Croatian guidelines for nutrition in the elderly (2011)
•
Croatian guidelines for the management of pancreatic
exocrine insufficiency (2012)
CROATIAN SOCIETY OF CLINICAL NUTRITION
3. Public Campaigns
Organization of public campaigns to raise awareness on proper nutrition and
malnutrition:
- Diet, Nutrition and IBD
- Nutrition Day
- Hospital Nutrition Days
CROATIAN SOCIETY OF CLINICAL NUTRITION
4. Nutrition Risk Screening Tool Implementation
•
Fighting against malnutrition in Croatia – Study 2013 ESPEN
•
gastroenterology departments of 9 hospitals in Croatia conducted a
multicentric study; NRS 2002 used to evaluate 1.786 patients
Projects in process:
•
Implementation of NRS 2002 into Hospital information system – nutritional
risk screening to become obligatory
upon hospital admission
•
Implementation of NRS 2002 in general practice
CROATIAN SOCIETY OF CLINICAL NUTRITION, CMA
5. Local Health Economic Studies
•
Cost of disease related malnutrition in Croatia – a hidden cost in the health care closet–
2012
•
The economic burden of disease-related undernutrition in selected chronic diseases – 2013
Clinical Nutrition
• Economic impact of enteral and parenteral nutrition usage on
healthcare costs – 2015
•
collaboration of key stakeholders in order to obtain local data on cost of malnutrition and economic
impact of enteral and parenteral nutrition usage on healthcare costs
Gold
Good
Optimal nutritional care for all
Where are we in Croatia?
Silver
Medium
Bronze
Low
?
Don’t
know
Routine screening policy
Hospital
Care home
Community
Evidence
Prevalence DRM
Reimbursement
Guidelines and standards
Nutrition guidelines
Cost of DRM
Hospital Care home Community
ONS
National nutrition plan
Economic benefits of
nutritional care
Audit of quality standards
Other
Stakeholders
Multi-stakeholder platform
Industry group
PEN
Geriatric Soc
Patient associations
Other
Quality standards
Tube
PN
Other
Implementation
Education and training
Postgraduate nutrition training MDs
Screening implementation
nurses
Other
Awareness programmes
Nutrition Day
Other
Hospital Care home Community
Screening
Care
Plan
Other
What does success look like in 3-5
years?
• Country wide nutrition policy – obligatory
nutritional screening /GP’s collecting
professional credits by routine screening/
• Implementation of nutrition support in all
hospitals, care homes and community
• Continous work on raising public awareness
– Getting the right message to the right people
(patients,…,government)
What are the likely road blocks?
• Standardization of the best pratice screening
tool, concordance with ICD-10
• Diagnose of malnutrition?
• Lack of knowledge on clinical nutrition in
hospital settings
• Lack of dietititians and specific competences
• Focus of the industry
• Cost-saving issues
What key steps that need to be taken
to deliver success?
1. Obligatory nutritional screening &
implementation of specific algorythms for
nutritional support
2. Development of „Multi stakeholder platform”
3. Availability of support (in all settings)
4. Public awareness