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(1) Background: Malnutrition in hospitalized patients is prevalent worldwide, but the severity of the issue is often underestimated by practitioners. The purpose of this study is to investigate the prevalence of malnutrition and inadequate eating behaviour in a geriatric sample. (2) Methods: Two hospitals participated with six wards on nutritionDay in 2017, 2018 and 2019. Nutritional status, food intake, and nutritional interventions were analyzed for all patients ≥ 65 years (n = 156), using the official nutritionDay questionnaires. Malnutrition risk is identified by Malnutrition Universal Screening Tool (MUST), malnutrition by the ESPEN criteria (European Society of Clinical Nutrition and Metabolism). (3) Results: According to MUST (n = 136) 16.9% (n = 23) were at medium risk of malnutrition, 33.8% (n = 46) at high risk of malnutrition, 28.1% (n = 38) were malnourished. Overall, 62.8% (n = 98) showed an inadequate eating behaviour during hospital stay. Moreover, patients with inadequate nutrition had significantly worse self-reported health statuses (p = 0.001; r = −0.276), were less able to walk on nutritionDay (p = 0.002; r = −0.255), had eaten little in the week before admission to hospital (p < 0.001; r = −0.313), and had an increased length of stay (p = 0.036; r = −0.174). (4) Conclusion: To identify malnourished patients is a significant barrier for practitioners seeking to administer specific, tailored interventions. Malnutrition screening protocols must be improved, just as nutrition monitoring in general.

Zusammenfassung Hintergrund Mangelernährung ist ein nach wie vor herausforderndes Problem in der Krankenhausversorgung, speziell bei geriatrischen Patient*innen. Dennoch findet das Thema in der Praxis nur wenig Beachtung. Ziel und Methodik Im Zentrum der vorliegenden Datenanalyse steht die Fragestellung, inwiefern sich der Ernährungsstatus von zuhause lebenden geriatrischen Patient*innen, von in der stationären Pflege lebenden, unterscheidet. Hierfür wurden Daten aus insgesamt 4 Erhebungen (3-mal nutritionDay plus eine zusätzliche Erhebung) zusammengefasst. Es konnten 258 Patient*innen (≥ 65 Jahre) in die Auswertung aufgenommen werden; ein Mangelernährungsrisiko wurde anhand des Malnutrition Universal Screening Tool (MUST), eine manifeste Mangelernährung anhand der ESPEN-Kriterien festgestellt. Ergebnisse Zu Hause leben 86,0 % ( n  = 222) der Patient*innen, in stationären Pflegeeinrichtungen 14,0 % ( n  = 36). Die in der stationären Pflege lebenden Patient*innen weisen eine ausgeprägtere Morbidität auf, sichtbar anhand der größeren Anzahl an in der Klinik verbrachten Nächten in den letzten 12 Monaten (Mdn 10,0 vs. 5; p  0,007), der höheren Anzahl der Medikamente (Mdn 9,0 vs. 7,0; p  0,002) sowie stärkeren Einschränkungen beim Gehen (Mdn 3,0 vs. 1,0; p  < 0,001). Sie sind signifikant älter (Mdn 86,0 vs. 78,0 Jahre; p  < 0,001) und weisen einen tendenziell höheren Anteil manifester Mangelernährung auf (35,7 %; n  = 10 vs. 20,1 %; n  = 40; p  0,062). Schlussfolgerung Sowohl zu Hause als auch in der stationären Langzeitpflege lebende geriatrische Patient*innen weisen einen erheblichen Anteil an Mangelernährung auf. Ein zuverlässig durchgeführtes Screening zu Beginn und im Verlauf des Klinikaufenthaltes ist in jedem Fall dringend erforderlich, da nur so die Betroffenen erkannt werden. Ein regelmäßiges Screening im ambulanten Bereich wie auch der stationären Langzeitpflege ist ebenso erforderlich.

Malnutrition remains a challenging problem in hospitals, especially among geriatric patients. The background and causes are actually well known but still underestimated in clinical practice. This study evaluated possible differences in rates of malnutrition risk and malnutrition in geriatric patients living at home and geriatric patients living in residential nursing homes. For this purpose, data from a total of 4 surveys (3 times nutritionDay plus 1 additional survey) were combined and evaluated. In this secondary analysis, 258 patients 65 years and older are included. Malnutrition risk is determined by the malnutrition universal screening tool (MUST) and malnutrition by the ESPEN criteria. Of the patients 86.0% (  = 222) live at home and 14.0% (  = 36) in residential nursing homes. The patients living in nursing homes have a higher morbidity and need of care. Indicators for the increased morbidity are a larger number of nights spent in the clinic in the last 12 months (mdn 10.0 vs. 5;  0.007), higher number of daily drug intake (mdn 9.0 vs. 7.0;  0.002) and greater limitations in walking abilities (mdn 3.0 vs. 1.0;  < 0.001). They are significant older (median 86.0 vs. 78.0;  < 0.001) and show a higher percentage of manifest malnutrition (35.7%;  = 10 vs. 20.1%;  = 40;  0.062). Geriatric patients living at home and in residential nursing homes show high rates of malnutrition. A malnutrition screening at the beginning and during hospital stay is urgently required in every case as this is the only way to identify those affected. In addition, regular screening in outpatient departments as well as in nursing homes is also necessary.

Particularly older people are affected by mobility restrictions and can go through the process of gradually becoming bedridden. This can potentially lead to extensive consequences for the individuals involved, which must be considered in their care. To bundle nursing implications related to the phenomenon of being bedridden in the field of long-term care and to provide impulses for research in nursing science. Research in relevant specialist databases (2003-2023) based on the criteria of a scoping review. In Germany there is a standard for maintaining and promoting mobility that addresses bed and local confinements but German language studies on these phenomena are rare. In the international context, these issues are researched more intensively, focussing on risk factors for the development of immobility and the negative consequences for those affected. The publications focus on the reduction of these factors, while less attention is paid to the organization of life in bed and the participation and involvement of those affected. The complexity of the phenomenon is not fully illustrated in current research. In order to develop a nursing perspective research projects that also include aspects of life in bed are a central aspect in order to take greater account of the reality of bedridden people's lives and their potential for participation and involvement.

Malnutrition is a major challenge in routine clinical practice and is associated with increased mortality. In the research project Prevention and treatment of malnutrition in geriatric patients in hospital funded by the Federal Ministry of Education and Research (BMBF), routine data were analyzed. The aim was to uncover the causes of malnutrition risks acquired in hospital. Anonymized data from nursing home residents with at least a 3-day hospital stay were analyzed. The study included a total of 2058 residents from 19 nursing homes. The malnutrition risk was assessed by the combined MUST/PEMU (Malnutrition Universal Screening Tool/Nursing Measurement of Malnutrition and its Causes) screening and malnutrition by ESPEN (European Society for Clinical Nutrition and Metabolism) criteria. Of the residents 36.2% (n = 744) had an initial risk of malnutrition and 12.7% (n = 262) were already malnourished. The proportions increased to 48.6% (n = 881) and 14.3% (n = 259) at discharge, respectively. The logistic regression analysis showed a significantly increasing probability of developing a malnutrition risk during the hospital stay with the diagnoses diseases of the respiratory system (OR 2.686; CI 95 1.111-4.575), chondropathy and osteopathy (OR 1.892; CI 95 1.149-3.115) and a higher BMI (OR 0.108; CI 95 1.038-1.181), more positive weight changes 6 months before hospital (OR 1.055; CI 95 1.017-1.094) and an increasing hospital stay (OR 1.048; CI 95 1.029-1.067). The identification of an initial malnutrition and the prevention of developing a malnutrition risk represent major challenges in clinical practise. Both are equally necessary.

Polypharmacy and the resulting problems lead to considerable consequences for those affected. There are also considerable problems with the medication management. Which interventions and programs for optimizing the supply of medication are available for nursing homes and which implementation problems can be expected? A literature search was carried out for interventional studies in nursing homes in Germany, with a focus on improving medication safety. A total of six programs were identified for which evaluation results are available. Despite a mostly multimodal approach with several pillars of intervention (e.g., medication reviews, further education and training, development of aids), the results are largely disappointing. The effects on the number of prescriptions in general, specific medication groups or outcome parameters such as hospital admissions could only be shown in one study, whereby, selection bias could also be at least partly responsible for this. Interdisciplinary collaboration and the implementation of medication recommendations formulated in reviews by the responsible physicians are the main problem areas. At the same time, too little attention is paid to the central role of nurses in the entire process and they are not actively promoted enough. This could be one of the reasons for the difficulties in implementation in practice. There are nearly no significant changes as a result of the interventions implemented in the studies reviewed. In particular, interprofessional cooperation, especially the skills of nurses and the reluctance on the part of physicians, should probably be given more attention.