Abstract
the BHSCT. As a result a significant proportion of the dietetic caseload consisted of patients from this NH, reducing capacity to see patients in other settings. Methods: The dietetic service met with NH management to discuss the nutritional management of the ’at risk’ patients and agreed to implement a ‘food first’ approach. An action plan containing specific recommendations with regards to a highly fortified, nutritious diet for patients at risk of malnutrition was agreed. The NH created a food fortification record to be completed by all members of staff on a daily basis. Results: Referrals: After 4 months of implementation of a ‘food first’ approach, referrals to the dietetic service from this NH had reduced by 75%. Nutritional Outcome: Prior to the project, 61% of patients on the dietetic caseload residing in this NH lost weight despite being on oral nutritional supplements. Four months on, 100% patients either maintained or gained weight with no recent weight loss reported. Conclusion: A dietitian monitors the NH to ensure food fortification and reduced referral rates are sustained. If this project was implemented within all NHs in the BHSCT area, there could potentially be a 75% reduction in NH referrals to CNDS. Saving in health care costs will be realised through increased capacity to effectively manage a wider cohort of adults at risk of, or with malnutrition.
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