Introduction Malnutrition in hospital can result in significant health and economic consequences. It can prolong hospital stay and can increase the risk of complications.
Objectives This cross sectional study was undertaken to assess nutrition status on acute in-patients using the Malnutrition Universal Screening Tool “MUST”, and compliance of completion of nutritional and hydration documentation such as nutrition care plans, food and fluid charts.
Methods Ten patients were randomly selected from ten wards across the hospital. Wards included four Acute Medical, three Care of the Elderly and three surgical wards. All one hundred patients' health records were reviewed to identify completion of the “MUST” assessment document; nutrition care plans, and food charts. Fluid chart were also reviewed to identify compliance in completion.
Results “MUST”—Of all the patients who had a “MUST” assessment undertaken 47% (n 26/55) were found to be low risk and 52% (n 29/55) had a medium or high risk score. Two of the 10 wards had more than 50% completion. No wards had 100% completion of “MUST” assessments. Forty five percent did not have a “MUST” score. Nutrition Care Plan documentation—Eight out of ten of the wards had a nutrition care plan for all or some of their patients. 60% were completed daily. Food chart—In nine out of the 10 wards all or some patients received a food chart. 66% were partially or fully completed. Fluid charts—In nine out of ten wards all or some patients had a fluid chart and 78% were partially or fully completed. Twenty two percent did not receive a fluid chart.
Conclusion The audit found suboptimal rates of completion of “MUST” assessment and nutrition care plan documentation. Over 50% of those assessed were found to be medium and high risk of malnutrition but it is unclear if they were the patients receiving the correct documentation. Repeat audits could identify this more clearly. We aim to put into place several improvements at ward level to increase compliance. These include; “MUST” calculators, a re-launch of “MUST” screening tools and supporting literature, ward based training. Senior management and ward sisters have been auditing own wards to ensure improvement in compliance with the introduction of ward directed monthly audits. These key clinical indicators of nutrition and hydration have also been based on key recommendations for CQC, DoH and NICE Guidelines.
Competing interests None declared.
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