263 Improving nutritional Care for Older Adults with hip fractures: insights from a multidisciplinary quality improvement workshop

Abstract

Abstract Background Enhancing nutrition is a crucial element of hip fracture care, as malnutrition poses increased mortality risk within the initial 120 days post-hip fracture. Aiming to address key considerations and potential challenges, the National Office of Clinical Audit Orthogeriatric Network conducted a quality improvement workshop focusing on nutrition. Methods A workshop exploring various elements of Orthogeriatric care was conducted in September 2022. Over 30 multidisciplinary stakeholders from various hospitals and clinical programs engaged in a survey and workshops exploring key components of Comprehensive Geriatric Assessment (CGA), including nutrition. Results Survey results indicated strong consensus on the inclusion of nutritional assessment and monitoring within the CGA for hip fracture patients. Focused small-group discussions highlighted the adverse effects of inadequate nutrition on wound healing, bone health, energy levels, the catabolic process, and frailty. The under-recognition of nutrition was highlighted. Identified barriers to optimal nutritional care included limited dietetic support, portion sizes, modified diets, repeated fasting, unclear guidance, literacy levels, and the availability of dementia-friendly equipment. Facilitators included access to dietetics support, involving family members and catering staff, enhanced oral hydration plans, protected meal times, proactive protein-based supplements, using ‘red trays’ for assistance, and ‘sip til send’ initiatives. This topic was further explored at the subsequent online network last March with a view to developing guidance on nutritional management of older hip fractures patients. Conclusion To optimise clinical outcomes, individualised nutritional interventions should be tailored to patients’ specific needs, considering local resources. The development of national consensus guidance aims to provide valuable information to enhance patient outcomes.