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Success Stories
October 14, 2022 - Health Care Professional
2021-Promoting Malnutrition Awareness & Nutrition Screening in Oncology at Guelph General Hospital
Malnutrition and weight loss are common in cancer patients. Progressive malnutrition can negatively affect clinical outcomes such as weight, treatment disruptions, quality of life and survival rates. ASPEN clinical guidelines recommend that patients with cancer should undergo nutrition screening to identify those who require formal nutrition assessment and the development of a nutrition care plan.ESPEN clinical guidelines recommend early nutrition intervention to increase oral intake for those who are malnourished or at risk of malnutrition.
Purpose: The purpose of our project was to determine the prevalence of malnutrition risk in the Ambulatory Care Outpatient Oncology Clinic at Guelph General Hospital (GGH) and to establish a nutrition screening process for the patients at this clinic.
Activities & Methods
- Attended Bullet round session with oncology nursing staff (Sept 29) to promote Malnutrition Awareness week (Oct 4-8).
- Introduced Canadian Nutrition Screening Tool (CNST) screening tool and proposed use with oncology outpatients.
- Conducted Lunch and Learn education session with oncology nursing staff titled: “Nutrition and Oncology: Early Interventions to Improve Outcomes.” (Nov 5).
- Dietetic Intern presented her oncology malnutrition case study report and the preliminary data from this project (Nov 19) as a staff educational event.
Protocol Established as follows:
- Clinical secretary to place CMFT tool on the front of patient chart.
- Patient completes (with RN assistance) the CNST (on admission and at the beginning of every treatment cycle) and ESAS (at each visit) forms.
- Early Intervention with positive screen (yes to both questions):
- Complete Registered Dietitian referral
- Provide “nutrition bag” with oral nutrition supplements, nutrition information, and RD contact information
Outcomes
- From Sept 21 to Dec 16, 82 CSNT screens were completed; of these, 20 were positive (i.e., 2 yes answers) or 24% of patients screened. This amounts to an increase of 766% of CNSTs completed and 416% new patients screening positive because of this protocol. This translates to approximately 0.63 new patients screening at risk per workday compared to 0.15 before Nov 5.
- The increased completion of the CNST has improved the detection of malnutrition in our out-patient oncology clinic. This enables our patients at risk of malnutrition to receive more timely and appropriate nutrition care, including an RD assessment and early nutrition interventions.
- The nutrition screening in oncology protocol is established and ongoing.
Submitted by Avery Zenker Dietetic Intern, Janine Robertson RD & Dianne Timmins, MSc(c), RD. For more details contact Janine Robertson, RD, GGH at jrobertson@gghorg.ca References available upon request