why does malnutrition matter?

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Why does malnutrition matter?. Improving Nutrition ….. Improving Care. Dr Alastair McKinlay NHS Grampian. Malnutrition Matters. It is common Its is treatable Improving nutrition has benefits for patients and their quality of care and safety. Ignore malnutrition and it will bite you. - PowerPoint PPT Presentation


Why does malnutrition matter?

Improving Nutrition .. Improving Care.

Dr Alastair McKinlay

NHS GrampianWhy does malnutrition matter?Malnutrition MattersIt is commonIts is treatableImproving nutrition has benefits for patients and their quality of care and safety.

Ignore malnutrition and it will bite you.Malnutrition is commonBAPEN Nutrition Week Survey 201010,044 individual patients

9668 age over 18 years with a MUST score

Medium risk malnutrition 14%High Risk 21%Total 34%

BAPEN Nutrition Week Survey 2010

By Country England 35%Wales 33%NI 38%Scotland 27%

By admission:Emergency 39%Elective 24%Not known 34%

Summary Malnutrition is still commonAssociated with illnessThe isolated, elderly etcCare Homes:BAPEN Nutrition Week Survey 2010

148 Homes in the UK1010 residents857 with MUST ScoresMedium risk 15%High risk 23%High and Medium risk 37%

Care Homes:BAPEN Nutrition Week Survey 2010

By Country:England 37%NI 31%Scotland 45%Overall 37%

In previous studies :Malnutrition unrecognised in 66%Most areas now use MUSTMUST is only of value if it is completed correctlyAnd if it is acted upon

Cost:Malnutrition is associated with poorer outcomes:Higher length of stayHigher MortalityReduced Healing of bed soresReduced quality of life?Not known

Financial CostsBAPEN Estimates (UK): 13 billion per annum NHS / Social CareScotland - 1.3 billionNot all can be recoveredIf we saved 10% 130 millon 1% 13 millionNICE estimates fourth largest costsaving areaWhat have we achieved in Scotland?Food, Fluid and Nutritional Care Standards 20032010: All Health Boards had improvedCurrent status unclear

They remain published They have not been rescinded

The Integrated Program for Improving Nutritional Care (INCHP) : Established in 2007. AIM: to support NHS staff to introduce the Nutritional Care in Hospitals Standards.Nutrition Champions:Major contribution to implementing new practiceAn effective, informal network

Health Facilities Scotland.

Health Facilities Scotland.Publication of national catering and nutritional services specification Food in Hospitals.

Commissioned the NUTMEG system to allow the nutritional analysis of menus.

Introduction of self-assessment tool to monitor progress of "Food in Hospitals."

Working with care homes.Ongoing work regarding nutrition in care homes.

National report "Eating Well in Care Homes for Older People published 2009

The Scottish Government established the Care Commission Now Social Care and Social Work Improvement Scotland) In 2002 to regulate care services.

NHS Education for Scotland (NES)NES has developed educational resources.Nutritional Care and Fluids module for Foundation Level Doctors.Part of the "DOTS" system.Will also be accessible via the Nutritional Care website (www.nutritioncare.scot.nhs.uk)

Improving Nutritional Care Programme Priorities"Making Meals Matter.Self-management (long-term conditions).Improving Transitions: between hospital and community.Achieving Sustainability.Case Study 1: Making Meals Matter:

Improving ward processes. Aim: to improve the effectiveness of mealtimes for 95% of patients in test areas

Led by nutrition champions and ward staff in NHS Greater Glasgow and Clyde and NHS Fife.

"Making Meals Matter" pack developed including poster, outlining key elements of effective mealtimes.

Making Meals Matter pack will be made widely available.

Case Study 2:"Making Meals Matter": volunteers at mealtimes.Aim: to ensure that 95% of patients receive the support they require to eat and drink at mealtimes. Led by NHS Ayrshire and ArranProgress:Volunteers recruited and trained.Risk mitigation processes established.Evaluation undertaken.Risk assessments completed.Testing currently underway.

Case study 3: Helping people with long-term conditions to self manage their nutritional care.Aims : 80% of people with COPD attending pulmonary rehabilitation clinic to demonstrate an increased knowledge and understanding of nutrition.Led by NHS Forth Valley and NHS LanarkshireProgress:Patients being supported to develop their own care plans.Introduction of the MUST screening tool.

Case Study 4: Improving transitions between care home and hospital.Aims: to improve communication relating to nutritional care in 95% of people being admitted to or discharged from care homes.Led by NHS Grampian

Progress:Identified test sites, Development of communication tool to record nutritional information at the point of admission and discharge.

SummarySustainability remains a significant challengeIntegrating nutritional care into day to day practice Developing new ways to motivate and interest clinical teamsEffecting changeChange is often difficult to see:Acorns do become oaksIndividual Brush strokes can produce a big picture.




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