Malnutrition is common in patients receiving anticancer treatment and is associated with reduced treatment tolerance, increased morbidity and mortality and higher healthcare costs. Results of the Malnutrition in Victorian Cancer Services (VCS) point prevalence study (2012) showed a wide variation amongst participating public health services in providing appropriate nutrition care for malnourished patients. Patients from health services with strong nutrition governance systems were more likely to receive individualised nutrition care from a dietitian.
The VCS Project Governance Committee identified a need for an information resource and toolkit for health service clinicians and teams with the aim to promote evidence based malnutrition practice, guide system-wide practice improvements to embed hospital quality and safety accreditation standards for nutrition care, and help close the gap in treatment variation.
Key stakeholders were identified and invited to participate. Working groups involving expertise from dietetics, nursing, medical oncology and haematology, clinical governance, quality and safety accreditation and health service management were recruited and surveyed to determine target audience and content needs.
The toolkit was developed comprising four chapters, namely;
1. Nutrition Governance Practices
2. Key Performance Indicators (KPIs) for malnutrition care
3. Identification, prevention and management of cancer malnutrition
4. Nutrition Service Delivery Models
Existing evidence was compiled and exemplar policy and technical documents were sourced and included from participating health services. Content was further developed and refined via structured surveys, piloting opportunities and teleconferencing at key time points to ensure stakeholder needs were met.
The toolkit will be available on the public domain via www.vic.gov.au/cancer. An implementation and sustainability plan has been developed with recommendations formed to assist with meeting longer term aims.