Outcomes of continuous process improvement of a nutritional care program incorporating serum prealbumin measurements

It has been reported that the risk of protein-calorie malnutrition (PCM) for hospitalized patient populations can be as high as 508. Left undiagnosed, PCM can lead to serious consequences, including increased morbidity and mortality. Visceral protein albumin is the traditional laboratory indicator of PCM. In the past few years, however, several other visceral proteins have been lauded as superior markers. We undertook several studies to test the effectiveness of using one of these, prealbumin, as an aid in nutritional assessment. We found prealbumin to be a sensitive measure of nutritional status, allowing for earlier assessment and intervention, and thus reducing length of stay. Based on these findings, our hospital has generated and implemented a multidisciplinary nutrition care program that meets the 1995 Joint Commission on Accreditation of Healthcare Organizations' Nutrition Care Standards. Prealbumin testing is an integral portion of this program; levels are determined on admission and repeated semiweekly until discharge. Use of this program has led to improved patient care and financial benefit to the hospital.