Report from Iceland
  • Country – Iceland
     
     
    Landspitali University hospital, located in Reykjavik, Iceland, is the largest workplace for nutritionists and dietitians in Iceland and they work both in the clinical setting and within the food service sector.
     
    Fall of 2009 Brynja Ingadottir, a specialized nurse, gathered a group of clinical nurse specialists, nutritionists and dietitians to start a joint collaboration on nutrition at Landspitali. The result is the Nutrition Day open for everyone interested in nutrition at the hospital.
     
    Nutrition Day is a half day program that aims to bring together different professionals and caregivers at the hospital, discuss urgent matters in the clinical setting and find ways to constantly improve. Every staff member at the University hospital is invited but the presentations are recorded for those who cannot attend.
     
    Malnutrition is a large problem in hospitals in most parts of the world, and Icelandic hospitals are no exception. Malnutrition was the major subject of the 2010 Nutrition Day. Professionals discussed this matter from several points of view on how to reduce the number of patients that become malnourished while in the hospital and are undernourished upon discharge. Special emphasis was put on addicts, the psychiatric patients, stroke patients and the elderly. Results from a new study on nutritional status of patients at several wards at Landspitali were introduced. The importance of active teamwork between the dietitian and the nurse, and how professionals have to look inside the structure for best results, were discussed. New clinical guidelines for nutrition were introduced for the first time.
     
    In 2011 the focus of the Nutrition Day was on the new clinical guidelines for nutrition, how it would be introduced within the hospital setting and last but not least, put into practice and made a part of everyday work at all wards. Marian van Bokhorst, PhD, RD from the Netherlands, presented how the introduction and a follow up in a similar project had been implemented in the Netherlands. The clinical guidelines for nutrition were reintroduced and the subject, “nutritional status of our patients matters” was discussed in detail by a surgeon and a nurse.
     
    The Nutrition Day in 2012 was devoted to further discussion on the new clinical guidelines for nutrition and the status of the project. A major emphasis was on introducing clinical studies and master researches by students from the University of Iceland that had newly been undertaken at Landspitali. A study on “estimating the energy and protein intake” and the development of a simple screening tool for that purpose was underway.  As also, a masters study “assessing protein and energy intake of heart and lung patients and comparing the results to the estimated need of the group of patients”. These studies were a team work between the Landspitali Unit for nutrition research and the Landspitali food services, emphasizing that both are important.  
     
    This year’s Nutrition Day was devoted to the subject of the importance of screening patients for malnutrition at admission using newly updated screening form. By filling out this screening form it is easy to detect the malnourished or at risk patients and take action right away. This is one of the vital points that the nutritionists and dietitians are emphasizing in each ward.  The content of the presentations was on the successes and failures the wards had been facing in the past two years while trying to improve their screening methods within a tight time frame. The Landspitali food services introduced their new menu, new rules and values used in meal planning for patients and future plans for further improvements in the service to the patients. A draft for a doctoral research thesis was introduced, focusing on nutrition intervention at a cancer unit and also a masters project where the focus will be evaluation of protein and energy enhanced diet menu.
     
    It is clear that research and development is underway at Landspitali University Hospital, the University of Iceland and at the Unit for Nutrition Research, and future in research looks exciting.
     
    Frida Run Thordardottir
    Dietitian, Sports nutritionist
    Icelandic ICDA Representative