Planejamento nutricional da alta hospitalar: breve revisão da literatura e proposta de instrumento de avaliação

Introduction: Due to its frequency and potential consequences, malnutrition is a worrisome condition in the hospital environment, especially in the case of adults admitted to intensive care units and others at high risk; malnutrition is associated with a higher risk of morbidity and mortality, prolonged hospital stay, higher frequency of readmissions, and increased costs. Although the absence of a planning for hospital discharge can aggravate these consequences, there are no guidelines for nutritional planning for hospital discharge that can be widely adopted in Brazil. Methods: A panel of experts was convened to assess the most relevant topics in the literature related to hospital discharge planning, discuss their experience in this regard, and propose an instrument that could guide and justify the importance of planned and safe nutrition discharge. Results: An organized and explicit discharge plan brings clinical and nutritional benefits to the patient, as well as advantages for family members and the health-care service. Nutritional care and better communication and guidance from the multiprofessional team prepare the patient and family members to reduce length of hospital stay and may avoid readmissions. Discharge planning requires the development of an individualized plan, as well as the education of the patient, family and caregivers; the nutritional care plan is inserted in the discharge plan. Based on these considerations, we propose an instrument that aims to systematize the nutritional discharge through the collection of the most relevant information related to the nutritional risk and the therapeutic approach to this risk, standardizing the communication with the patient, their caregivers, and the health-care team. Conclusions: The instrument presented here should be tested in clinical practice, and it is hoped that it can allow a better follow-up of the patient’s journey, leading to a more successful hospital discharge.