Over the last five years, the combined Dutch efforts to fight malnutrition have led to gradually decreasing malnutrition prevalence rates in all health care settings in the Netherlands. The following partners participated in our succesful 'Dutch Approach'
The Dutch Malnutrition Steering Group (DMG) was established in 2005. This is a multi-professional group, consisting of physicians (e.g. a surgeon, geriatrician, anesthesiologist, general practitioner), dietitians, nurses and policy makers. Each participant represents their own profession and is able to make decisions on behalf of their profession. As an example the participating dietitian represents the Dutch Dietetic Association, the General Practitioner the Dutch GP association and so on. We have thus created an ability to draw on a wide range of resources as well as being able to resolve any issues more efficiently. At its start the Dutch Malnutrition Steering Group aimed to fight malnutrition only in the hospital setting. Later this was expanded to nursing homes as well as to the home care setting. The DMG has developed a consistent methodology to treat malnutrition. The methodology combines good clinical practice, scientific knowledge and field experience into simple instruments for screening and treating malnutrition.
The Dutch Annual Measurement of Care Problems (LPZ) started measuring malnutrition cross-sectionally in all health care settings in 2004. This provides new malnutrition prevalence data every year, with approximately 30,000 patients participating per year. This annual prevalence measurement has proved to be very important in convincing policymakers about the seriousness of the problem caused by disease related malnutrition in all health care settings.
We are now using the LPZ data to show trends in prevalence rates over several years.
The Dutch Ministry of Health is an important partner in the combined efforts to tackle malnutrition in the Netherlands. The Ministry has not only funded the majority of the projects to tackle malnutrition but it has also has introduced mandatory indicators for screening and treatment of malnutrition in hospitals (2007 and 2008), nursing homes (2009) and home care (2010). It is therefore obligatory for institutions and home care organisations to participate in projects to fight malnutrition.
NESPEN is the Dutch Society for Clinical Nutrition and Metabolism. NESPEN organizes two scientific meeting every year as well as an educational session for dietitians involved in research. NESPEN is now working on an educational programme so that medical doctors, dietitians and nurses can obtain a degree in clinical nutrition. This programme will also contain elements of the ESPEN Life Long Learning (LLL) programme in Clinical Nutrition and Metabolism. For more information see www.lllnutrition.com