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Improving Nutritional Care in Bristol

Improving Nutritional Care in Bristol. Sharon Sexton Medicines Management Dietitian NHS Bristol. Current Situation. Unidentified malnutrition Low use of MUST/screening in community Variable understanding of risks associated with malnutrition Limited dietary advice available/offered

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Improving Nutritional Care in Bristol

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  1. Improving Nutritional Care in Bristol Sharon Sexton Medicines Management Dietitian NHS Bristol

  2. Current Situation • Unidentified malnutrition • Low use of MUST/screening in community • Variable understanding of risks associated with malnutrition • Limited dietary advice available/offered • Limited dietetic services across Bristol • Increasing spend on oral nutritional supplements

  3. Initial Findings from training in Bristol Care Homes(delivered by Rachel Cooke) • In one care home, just 3.5% of those screened were screened correctly • In the home where screening was most accurate, 75% of those screened were screened correctly

  4. Initial Findings from Training in Bristol Care Homes(delivered by Rachel Cooke) • Average incidence of malnutrition: 45% (17% medium risk, 28% high risk) • ‘National average’ taken from results of the BAPEN Nutrition Screening Week survey 2010 (37% of residents at risk of malnutrition)

  5. Objectives of Role • Promote validated guidance • Increased identification of malnutrition • Increased screening for risk of malnutrition • Pathway for treating malnutrition • Appropriate prescribing • Support for health professionals • Training

  6. Key Professionals • GPs • Community nursing • Practice pharmacists • Dietetic teams • Intermediate Care • Care Homes • Nursing staff • Catering staff • Public Health

  7. Developing Guidance on screening • Primary Care Nutrition Working Group • Range of stakeholders • NHS Islington guidance adapted with permission • Succinct • draft

  8. The Guidance • MUST (Malnutrition Universal Screening Tool) • Care Pathway • Guide to best practice in prescribing oral nutritional supplements • Range of information on starter packs/feeds

  9. Distribution of guidance • Meetings at all Bristol GP practices • Distributed to community nursing teams • Care settings • Links with practice pharmacists • Promoted through training

  10. Conference Update • Conference held 7th November 2012 • Care homes, community nurses, stakeholders • Raise awareness of incidence of malnutrition

  11. Key Themes • Training provision should be ongoing and available for all teams • Housebound without nursing input hard to reach and may be most vulnerable

  12. Next Steps • Adapt guidance based on feedback • Offer further training to: • care homes • community nursing • Intermediate care • Reablement teams • Rapid response teams

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