1941 Working as a multidisciplinary team to reduce weight loss - a quality improvement project to improve nutrition in older patients

Abstract

Abstract Introduction Weight loss is common during acute hospital admissions, and can be devastating to the older patient where weight loss is associated with an increase in mortality over a 12-month period. Patients who lack the ability to communicate their food preferences are at risk of receiving food they do not like, especially as food orders are often taken when family/carers are not present. Methods While working on a Department of Medicine for Older People and Stroke (DMOPS) ward, we worked with the Multidisciplinary team (MDT) with the aim of reducing weight loss. We implemented two interventions. The first being ‘MUST Mondays’, where patients were weighed and had a Malnutrition universal screening tool (MUST) completed on admission to the ward, and then weekly. We also implemented A3 Laminated menus - where patients and their families/carers were given food choices for the week in advance, and could use a marker to identify foods they did/did not like. These were then displayed above the bedspace. All patients were over the age of 65. We excluded patients who were actively dying, patients who were aiming for weight loss (Such as in fluid overload) and patients who were admitted for fewer than 8 days. Results Prior to putting the interventions in place, we audited 23 patients admitted over a 3-month period. 70% of patients lost weight over the course of their admission, and 48% had MUST assessments completed weekly. We re-audited 5 months after the interventions were implemented, we audited 20 patients over a 5-month period and found 55% lost weight over the course of their admission, and 80% had weekly MUST assessments. Conclusion Working as an MDT to put in place small interventions can have a meaningful impact on reducing weight loss in older patients during acute hospital admission.