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April 5, 2017 - Health Care Professional

Senior Friendly Hospital Accelerating Change Together in Ontario: A quality project to screen for and raise awareness on malnutrition in hospitalized patients

Over the past year, a group on a General Internal Medicine unit at The Ottawa Hospital has been working to raise awareness of malnutrition for patients admitted to hospital. The results and information shared from the Canadian Malnutrition Task Force study from 2013 was used in this quality project. The vision of the Senior Friendly Hospital (SFH) strategy, which is supported by Health Quality Ontario, is to enable seniors to maintain optimal health and function while they are hospitalized. Malnutrition is one of several processes that can contribute to patients requiring more help with activities of daily living, such as bathing, transferring or eating, after a hospital stay. The team focused on raising awareness of malnutrition and set their goal to screen all patients over the age of 65 for nutrition risk on admission and have a plan of care to address or maintain their nutritional needs. The two questions from the Canadian Nutrition Screening Tool are embedded in the nursing history form, which is completed on admission to hospital. Monthly audits were conducted and measured: • Percent of patients with nutrition screening completed on nursing history form • Percent of patients weighed on admission • Percent of patients at risk for malnutrition and a dietitian consulted • Percent of patients requiring assistance to eat that were recorded on the “assist with meals list” • Percent of patient with three meals documented on nursing flowsheet Before this project began, only 10% of patients were screened and weighed on admission. As the project wrapped up in January 2017, 75% of patients now have nutrition screening completed and 80% are weighed on admission. Patients receive assistance with meals, and barriers to optimal nutrition are identified, including noting which patients need assistance with meals or encouraging family and friends to join their loved one at meal times. Meal times are posted on the nursing unit and in the patient rooms. The education has been rolled out across the other two General Internal Medicine units at the hospital as well, including additional nursing education days and implementation of the Med Pass program. The results have been presented in several different venues including: • Poster presentation at the Regional Geriatric Program of Eastern Ontario annual general meeting • Poster presentation at the Senior Friendly Hospital ACTION Collaboration Showcase • Presentation at The Ottawa Hospital’s Quality Initiatives Showcase • Upcoming presentation at the Canadian Gerontological Nursing Association’s Biennial Conference in May 2017 Submitted by Becky Grant RD CTU & Family Medicine | Médecine The Ottawa Hospital | L’Hôpital d’Ottawa

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