La Semaine canadienne de sensibilisation à la malnutrition, notre campagne annuelle, vise à améliorer l’apprentissage des cliniciens, des fournisseurs de soins de santé et des consommateurs sur la malnutrition. Les dates de 2024 sont à suivre.
I wanted to let you know about a hospital alliance that took the message of the CMTF to heart and has completed so many practice changes that I feel they can be an inspiration to other hospitals. In 2014, the Huron Perth Healthcare Alliance (HPHA) nutrition department embarked on their journey to reduce hospital malnutrition by increasing awareness and promoting a culture change. Through the Pressure Ulcer Prevention and Management Order Set, a Dietitian consult order is initiated when the Braden scale score is less than 19, indicating a level of risk. This change in practice increased referrals but more importantly the profile of nutrition as an important factor in the healing of wounds. With continuous pressure related to budget reduction, the department was faced with a 3% reduction target, which inevitably would lead to patient menu cuts. Senior leadership supported the efforts to optimize the nutrition provision to all patients and believed that preventing and treating malnutrition is vitally important to the organization at large. Therefore, protein levels were increased on all patient menus to meet most current evidence based guidelines. Since then they have implemented:
• The use of Mini Nutritional Assessment screen by the Nutrition and Food Services Supervisor as well as a volunteer Meal Buddy system in Complex Care and Rehab units.
• The use of Personal Support Workers (PSW) to set up meal trays and open packages for patients, as well as a designated stroke dining room to promote increased socialization which has resulted in documented improvements in dietary intake.
• Complete menu nutrition analysis via ESHA research software to make strategic improvements to the meal and oral nutrition supplements to increase the protein and decrease total sodium content of patients' diets.
• Education of hospital staff on malnutrition and the new practice changes via a variety of forums such as Clinical Leaders & Directors meeting, Nursing Matters and Nursing Skills Fair, Surgical Care team meeting, Nutrition and Food Services staff education sessions, as well as specific care area meetings.
• The Canadian Nutrition Screening Tool (CNST) was implemented into their Admission Assessment in the Meditech system in October 2015 and has greatly improved the number of malnourished patients that are identified and provided with medical nutrition therapy.
• Protection of patient mealtime support by various supportive teams including laboratory and imaging, as well as allied health therapy programs.
Just this month they will be rolling out mandatory charting by nursing staff of patients oral intake of food using the following percentages as a guide (100%, 75%, <50%, none) and a comment section to identify specifics related to suboptimal intake. As you can see, the Nutrition Team at HPHA has facilitated change, and followed all 6 of the CMTF recommendations. They continue to actively promote the reduction of malnutrition in their hospitalized patients.
Sergio Nocent RD Contact person at Huron Perth Healthcare Alliance: Jane Graul at jane.graul@hpha.ca 519-272-8210 x 2411
