Nutritional screening among patients with cancer in an acute care hospital: a best practice implementation project

Abstract

This project sought to improve the nutritional screening practice among registered nurses in caring for adult patients with cancer. This project used the pre- and post-implementation audit strategy using Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice (JBI-PACES) module. The audit, feedback and re-audit sequence was the strategy used to improve clinical practice. This project ran over three phases during a 5-month period from July to November 2011. This project utilised three criteria from the JBI-PACES. The criteria are: (i) a validated screening tool is used to identify patients at risk for malnutrition; (ii) patients are screened upon admission using a validated screening tool; and (iii) appropriate action plans are initiated when at-risk patients for malnutrition are identified. According to the pre-implementation audit, only Criterion 1 showed 100% compliance. Criterion 2 and 3 showed 96% and 46% compliance, respectively. The audit team identified four barriers and developed action plans, which included a simplified nutritional screening tool and empowerment of the nurses for dietician referral. The post-implementation audit showed 100% compliance rate achieved for all the three criteria. This project used the pre- and post-audit strategy to translate evidence into practice. It demonstrated not only that implementation of best practice is possible in a busy oncology ward, but also showed a remarkable improvement in the nutritional screening of patients with cancer.