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Aktuelle Ernährungsmedizin 2019; 44(04): 261-268
DOI: 10.1055/a-0894-1224
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© Georg Thieme Verlag KG Stuttgart · New York

Ernährungsberatung im Spannungsfeld zwischen Klinik und ambulanter Versorgung

Nutritional Counselling at the Edge Between Clinic and Outpatient Care
Heike Weiss
Klinik für Allgemein- und Viszeralchirurgie, Klinikum Magdeburg gGmbH
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Publication History

Publication Date:
20 August 2019 (online)

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Zusammenfassung

Dass mit der Diagnose Krebs gleichzeitig eine erhöhte Gefahr für die Entstehung oder auch Verschlimmerung einer Mangelernährung einhergeht, ist eine seit fast 40 Jahren bekannte Tatsache. Umso wichtiger ist es, dass mehr dafür getan wird, um die kontinuierliche Versorgung dieser Patienten mit ernährungstherapeutischen Maßnahmen zu verbessern.

Es zeigt sich, dass im stationären Bereich mittlerweile Strukturen bestehen und Spezialisten verschiedenster Professionen daran arbeiten, die Ernährungssituation der Patienten zu verbessern. Einen massiven Einschnitt erfahren viele Patienten jedoch unmittelbar nach ihrer Entlassung. Ernährungstherapeutische Maßnahmen, die in der Klinik initiiert wurden, enden oft mit dem Tag der Entlassung. Die Ursachen hierfür sind vielfältig. Fehlende Strukturen im ambulanten Bereich, unzureichende Kommunikation zwischen Klinik und übernehmendem Haus- oder Facharzt oder eine ungenügende Aufklärung der Patienten über Sinn, Funktion und Ablauf der Ernährungstherapie verhindern deren kontinuierliche Fortsetzung nach der Entlassung.

Ein erster Schritt, um diesen Übergang zu verbessern, vollzog sich 2017 mit der gesetzlichen Verankerung des Entlassmanagements. Nun gilt es in diesem Sinne auch die Bedingungen für das Entlassmanagement der Patienten mit supportiver Ernährungstherapie so zu formulieren und zu strukturieren, dass keine Brüche im Behandlungsverlauf durch Entlassungen entstehen können. Dies führt letzten Endes nicht nur zu einer höheren Lebensqualität und Zufriedenheit bei den Patienten, sondern auch durch eine Verbesserung der Ernährungssituation zu weniger und kürzeren Klinikaufenthalten, die sich dann auch gesamtwirtschaftlich positiv auswirken.

Abstract

The fact that the diagnosis of cancer is accompanied by an increased risk of developing or worsening malnutrition is unfortunately an apparently accepted fact. Therefore, it is important that everything is done to improve and continue nutritional care of these patients.

It has become apparent that structures were established in the inpatient area where a multiprofessional team is working to improve the nutritional situation of the patients. However, the patients then experience a massive incision regarding their nutritional care when discharged from the hospital. Nutritional therapy initiated in the clinic often ends abruptly at the day of discharge. The causes for this are manifold. Lack of structures in the outpatient area, inadequate communication between the clinic and the general practitioner or the inadequate education of patients about the meaning, function and course of nutritional therapy prevent their continuous continuation after discharge.

A first step to close this gap took place in 2017 with the legal anchoring of the dismissal management. In this sense, it is now also necessary to formulate and structure the conditions for discharge management of patients with supportive nutritional therapy in such a way that no breaks in the course of treatment can result from layoffs.

In the end, this not only leads to a higher quality of life and satisfaction among the patients, but also through an improvement in the nutritional situation to fewer and shorter hospital stays, which then also have a positive macroeconomic effect.

Schlüsselwörter

Krebs - Ernährung - Mangelernährung - Patienten - Entlassmanagement

Keywords

cancer - nutrition - malnutrition - patient - arrangement of discharge
 

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