Introduction Malnutrition is both a cause and consequence of ill-health and affects 15-40% of hospital admissions.1 The National Health Service could save £226 million pounds per annum by providing nutritional support to undernourished patients.2 NICE guidelines for “nutrition support for adults” advocate screening of all hospital inpatients on admission, weekly thereafter and action depending on the risk score.3 Our hospital uses “nutritional risk score” (NRS) chart as a screening tool.
Methods We wanted to assess whether our hospital practice complies with these guidelines. A pro-forma was developed in collaboration with the clinical governance department and a snap shot audit was carried out in May 2009. NRS data were collected prospectively for all medical inpatients on the same day, while outcome and length of stay were examined at a later date. Waiting times, nutritional supplementation and outcome were recorded and analysed using SPSS system.
Results 226 case notes were reviewed of which 55% patients were females. Mean age was 77 (±12 SD) years.78% were admitted from their own home, 20% from nursing home and 2% were transferred from other units. Only 15% of patients were weighed on admission. The NRS charts were partially filled in 17% of patients, completely in 38%, while 45% had no chart. 33% of NRS charts were reviewed weekly, 33% were reviewed intermittently but not weekly and the remaining were not reviewed. Based on the NRS score, patients were divided into groups and the results are demonstrated in the Abstract 058.
Conclusion The data show that we are poorly compliant with the NICE guidelines for “nutrition support for adults” in the acute inpatient setting. The length of stay and high mortality in patients with moderate and high NRS scores emphasises the need for vigerous screening for malnutrition. We suggest that the NRS is a mandatory tool in the admission documentation of all patients.
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