What's covered

About Our Standards

HSO standards are the foundation on which leading-edge accreditation programs and great public policy are built. Standards create a strong health care structure that the public, providers, and policy makers can rely on, assuring high quality health services where it matters most.

HSO’s standards are formatted using the following structure.

  • Subsection Title: A section of the standard that relates to a specific topic.
  • Clause: A thematic statement that introduces a set of criteria.
  • Criteria: Requirements based on evidence, that describe what is needed by people to achieve a particular activity. Each criterion outlines the intent, action, and accountability.
  • Guidelines: Provide additional information and evidence to support the implementation of each criterion.

About This Standard

The introduction and scope sections of this standard describe its need, purpose, and applicability.

This standard will be undergoing periodic maintenance. HSO will review and publish this standard on a schedule not to exceed five years from the date of publication.  This standard is intended for conformity assessment.

This is the first edition of CAN/HSO 5066:2021(E) Malnutrition Prevention, Detection, and Treatment.

This standard outlines requirements for and provides guidance in the following areas:

  • Patient-centred care
  • Multimodal nutrition care
  • Nutrition risk screening
  • Nutrition assessment
  • Standard nutrition care
  • Advanced nutrition care
  • Specialized nutrition care
  • Early mobilization
  • Transitions of care

Visual pathways to optimize nutrition can be found in Annex A.

Who this standard is for



CAN/HSO 5066:2021(E) Malnutrition Prevention, Detection, and Treatment provides acute care organizations with best practices to prevent, detect, and treat malnutrition in adult and pediatric inpatients.

This standard addresses processes and protocols to:

  • Identify patients at risk of malnutrition at admission
  • Diagnose malnutrition
  • Implement an integrated nutrition care plan to prevent and treat malnutrition
  • Provide nutritious and culturally acceptable food and reduce barriers to food intake for patients
  • Monitor nutrition intake and nutrition status changes for patients
  • Provide treatment for malnourished patients throughout their hospital stay
  • Facilitate organizational changes to implement and sustain improved nutrition management
  • Focus on nutrition care in the discharge plan when patients are transferred to other care and community settings


This standard provides guidance to patients and families, health care professionals, and leaders at all levels of an acute care organization. It is intended to improve the management and quality of nutrition care provided to adult and pediatric patients admitted to hospital. The standard applies to national and global acute care organizations in rural, urban, and remote areas. It is not likely to apply to patients whose care management is palliative, and these patients may be excluded at the discretion of the organization.

Adopting the standard in a complex acute care setting may be challenging. To maximize feasibility and improve timely uptake, organizations should adapt a systematic approach to changing practices based on implementation science. Implementation efforts should be guided by 1) determining who needs to do what differently; 2) assessing barriers and facilitators to change; 3) identifying intervention strategies to overcome these barriers; and 4) understanding how changes in practice can be measured (French et al., 2012).

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