How does a 7-day nutrition model of care impact time to intervention and hospital-acquired malnutrition in an acute trauma ward? An observational study.
Sarah Phillips1, Caitlin MacCana1, Aruska D’Souza1, Laeticia Hargreaves1, Hilda Griffin1 1The Royal Melbourne Hospital, Parkville, Victoria, Australia
Abstract
Background: The Royal Melbourne Hospital trauma service introduced an enhancement of dedicated dietetics resources and introduced a 7-day nutrition model of care. The aim of this project was to measure the effect of this change on referral response times, frequency of nutrition contact and incidence of hospital-acquired malnutrition.
Methods: Retrospective observational data was collected from electronic medical records over a three-month period before and after the enhancement. Statistical analysis was performed using Stata BE, version 17.
Results: Data was analysed from 716 patients [73.3% males, median age 46 (IQR 29-65) years] and 651 patients [69.9% males, median age 49 (IQR 31-67) years] respectively pre and post the enhancement. Referral response time reduced from median 23.0 (IQR 9.0-38.5) hours to 18.5 (IQR 2.0-27.0) hours (p=0.029) and the number of patients accessing nutrition services increased from 110 (15.4%) to 165 (25.3%), p=<0.001. Frequency of nutrition contact remained stable (median 2.0 (IQR 1.0-4.0) contacts per patient pre and post enhancement (p=0.503). Hospital-acquired malnutrition decreased from 15 cases to 6 cases (65.2% to 22.2% of total diagnosed malnutrition cases in this cohort, p=0.004). Length of stay (LOS) for malnourished patients also decreased from median 24.5 days (IQR 19.0-39.0) to median 16.0 days (IQR 9.5-25.0), p=0.046. Discussion/implications: Evaluation of a 7-day nutrition model of care demonstrated improved time to intervention while maintaining frequency of nutrition contact. This may improve patient outcomes such as incidence of hospital-acquired malnutrition and LOS. A more in-depth study of factors contributing to hospital-acquired malnutrition in this cohort is recommended.
Biography
Sarah is a Senior Clinical Dietitian in intensive care and trauma at The Royal Melbourne Hospital. She has six years’ experience across regional and tertiary health services in Victoria and her current role includes expanding the trauma nutrition service to a 7-day model of care. Outside of work you will find her trying to kick her first goal from the backline of the footy field or working on perfecting handmade pasta.