ESPEN 2013 - Late breaking abstract submission

Late Breaking Abstract

ESPEN13-1822

EFFECTIVENESS OF IMPLEMENTING A NURSE LED POLICY FOR THE MANAGEMENT OF MALNUTRITION

E. Baggaley ¹L. Whincup ²K. E. Ashman ^3,*A. L. Cawood ³D. Davies ¹E. Burns ¹R. J. Stratton ³

¹Medicines Service, ²Adult Services, City Health Care Partnership CIC, Hull, ³Medical Affairs, Nutricia Ltd, Trowbridge, United Kingdom

Rationale: National guidelines^1,2 show cost savings can be made by implementing screening and management of malnutrition. This project assessed the impact of implementing these guidelines locally on nutritional care and healthcare (HC) use.

Methods: A local policy for monthly nurse led ‘MUST’ screening, initiation of care plans for malnutrition, including oral nutritional supplements and dietary advice for high risk residents², and monthly review, was implemented in 5 care homes (4 residential, 1 nursing) (n132, mean age 83y SD 9). Data was collected on nutritional measures, use of appropriate care plans and HC use 3 months before and after the policy was introduced, and statistically analysed (McNemar and Fisher’s exact test). Cost of interventions and HC use were assessed^3,4.

Results: A policy for screening and managing malnutrition significantly improved; documentation of height (66 vs.100% p<0.001), weight (42 vs. 98% p<0.001), nutrition screening (36 vs. 98% p<0.001) and use of appropriate care plans (56 vs. 98% p<0.001). HC use decreased with a significant reduction in HC professional contacts (26% p=0.001), fewer hospital admissions (37% p=0.082) and infections requiring antibiotics (28% p=0.096). The associated reduction in HC costs (-£224.22) more than offset the costs to screen, manage, and review residents (+£36.31) demonstrating estimated savings of -£187.91 per resident for 3 months (-£751.64 annually) (£0.85 = €1).

Conclusion: The project demonstrated that screening and appropriate management of malnutrition can be improved by implementing a nurse led local policy mainly in residential homes. The costs to screen and manage malnutrition were more than offset by the reduction in HC costs. The impact of managing malnutrition on a wider scale needs further evaluation.

References: (1) NICE (2012) Quality Standard 24 (2) www.malnutritionpathway.co.uk (3) Curtis L. (2011) Unit Costs (4) Monthly Index of Medical Specialities (2011)

Disclosure of Interest: E. Baggaley: None DeclaredL. Whincup: None DeclaredK. Ashman Other: Employee of NutriciaA. Cawood Other: Employee of NutriciaD. Davies: None DeclaredE. Burns: None DeclaredR. Stratton Other: Employee of Nutricia

Keywords: malnutrition management