Lost in Transition: Insights from a Retrospective Chart Audit on Nutrition Care Practices for Older Australians with Malnutrition Transitioning from Hospital to Home.

Abstract

Care transitions from hospital to home for older adults with malnutrition present a period of elevated risk; however, minimal data exist describing the existing practice. This study aimed to describe the transition of nutrition care processes provided to older adults in a public tertiary hospital in Australia. A retrospective chart audit conducted between July and October 2022 included older (≥65 years), malnourished adults discharged to independent living. Dietetic care practices (from inpatient to six-months post-discharge) were reported descriptively. Of 3466 consecutive admissions, 345 (10%) had a diagnosis of malnutrition documented by the dietitian and were included in the analysis. The median number of dietetic visits per admission was 2.0 (IQR 1.0-4.0). Nutrition-focused discharge plans were inconsistently developed and documented. Only 10% of patients had nutrition care recommendations documented in the electronic discharge summary. Post-discharge oral nutrition supplementation was offered to 46% and accepted by 34% of the patients, while only 23% attended a follow-up appointment with dietetics within six months of hospital discharge. Most patients who are seen by dietitians and diagnosed with malnutrition appear lost in transition from hospital to home. Ongoing work is required to explore determinants of post-discharge nutrition care in this vulnerable population.