Lise Søndergaard

Alcohol screening in North Denmark Region hospitals: Frequency of screening and experiences of health professionals

Background: Alcohol consumption is a risk factor for disease, disability and death. Approximately 20% of all hospital admissions are alcohol related. In Denmark, hospitalised patients undergo systematic health risk screenings to establish preventive initiatives if the screening detects a risk. The frequency and usability of alcohol screening and health professionals’ experiences of the screening is unknown. Aim: To examine the frequency and usability of alcohol screening at North Denmark Region hospitals, as well as health professionals’ experiences of screening for alcohol. Methods: This study consisted of an initial audit of 120 patient records from medical and surgical units at four hospitals assessing information on alcohol screening. This was followed by six focus-group interviews with health professionals (n = 20) regarding their experiences of conducting alcohol screening. Results: Among overall health screenings, screening for alcohol and tobacco smoking was performed most frequently (81.8% and 85%). Alcohol screening scored the lowest percentage for usability (67.7%). Hospital-based alcohol screening was perceived ambiguously leading to a schism between standardised alcohol screening and the individual needs of the patient. Health professionals described different patient types, each with their perceived needs, and screening was associated with taboo and reluctance to engage in alcohol screening of some patient groups. Conclusion: This study revealed factors that influence health professionals working with hospital-based alcohol screening. The variation in and complexity of alcohol screening suggests that screening practice is an ambiguous task that needs continuous reflection and development to ensure that health professionals are prepared for the task.

Functional training and timed nutrition intervention in infectious medical patients

Background/Objectives:Bed rest and decreased nutrition intake in hospitalized patients have been shown to impair the clinical course negatively, including reduced function after hospital stay. Recent reviews have shown that early physical rehabilitation for acute hospitalized old adults leads to functional benefits. The aim of our study was to assess whether it was possible to influence nutrition intake, loss of muscle function and quality of life, with an evidence-based intervention in acutely ill hospitalized infectious medical patients.Subjects/Methods:For potentially frail patients, functional training three times weekly, and an individually adjusted self-training program for use 1–2 times daily, was given by a physiotherapist. Oral nutritional supplement with 5–10 g whey protein was timed straight after training 2 times daily, and dietetic advice was provided. A historical control group was used to compare nutrition intake. Functional measures and health-related quality of life (HRQoL) were done on admission and discharge.Results:The study included 59 patients in the intervention group. Historic control included 145. Energy and protein intake increased by 3053 kJ (P<0.001) and 28 g of protein (P<0.001), compared with historic controls. Functional parameters (De Mortons Mobility Index (DEMMI), Timed Up and Go and the 30-s chair test) and HRQoL improved significantly for the overall group, most remarkably in patients >70 years of age, from hospitalization to discharge.Conclusion:The intervention with dietician and timed oral supplement to functional training by physiotherapist in hospitalized infectious medical patients improved function as well as nutrition intake and HRQoL.