Audit in clinical practice: evaluating use of a nutrition screening tool developed for trauma nurses

Abstract

Background: The Nutrition Checklist screening tool was developed by dietitians for the trauma nursing staff at the John Radcliffe Hospital, Oxford. Its purpose was to identify those at nutritional risk so that dietetic assessment and intervention could be implemented. This paper focuses on a single day audit that was devised 5 months post‐initiation of the Nutrition Checklist. Method: Data from 48 nursing care plans was used to measure compliance of recording a nutrition score (and re‐scoring where applicable) alongside the timing of dietetic referral and intervention. Results: Sixty‐seven per cent (32/48) of trauma patients had a nutrition score recorded, however only 75% (24/32) of these patients were scored within 24 h of admission. Of those due for reassessment, only 38% (11/29) were rescored. Eighty‐eight per cent (23/26) of the patients who scored ≥ 3 (automatic referrals) were referred to the dietitian; the dietitian documented 100% (23/23) of referrals. Conclusion: The audit suggests limited use of the screening tool by nurses. Collaboration between the nursing team, dietitian, consultant team, catering and clinical auditors could improve compliance in the use of the Nutrition Checklist and ultimately lead to improved clinical practice in nutritional care delivery. Despite its limitations, the audit exercise was a valuable learning experience in the maintenance of a nursing Nutrition Checklist. Further research is needed to assess whether the introduction of such a screening tool improves patient outcomes by minimizing nutrition‐related complications.