A point prevalence study in 2012 revealed that 29% of Moorabbin Hospital cancer patients (in-patients 75%, ambulatory 22%) were malnourished.
The elements of a dietetic services best practice model for cancer patients include a screening process to ensure access, appropriate assessment, individualise intervention and timely and adequate follow-up. Nurse led nutritional screening using the Malnutrition Universal Screening Tool (MUST) and Malnutrition Screening Tool (MST)) was introduced at Moorabbin Hospital several years ago, however, completion compliance is variable. Evidence suggests guidelines for nutritional screening and nutrition care alone are not enough to bring or maintain a change in practice.
Aim
• To develop, pilot and evaluate a nutrition support program using a Nutrition Nurse Champion model of care in the Medical Oncology and Chemotherapy Day Unit (CDU) Wards at Moorabbin Hospital, Monash Health.
Methods
Development and implementation of:
• An evidenced based Nutrition Nurse Champion training workshop and model of care
• Competency Based Assessment Evidence Tools for nursing nutrition procedures
• Nurse Satisfaction and Patient Centred Care/Experience Surveys
Results
• Nutrition screening compliance with MST (CDU) improved from 40 % pre implementation to 83% post implementation: MUST (Medical Oncology Ward) improved from 75% pre implementation to 94% post implementation
• Patient experience indicated satisfaction
• Nutrition improved its ranking of importance for nursing from no.2 pre implementation, to equal no.5 post implementation as one of 10 factors considered significant in preventing functional decline in oncology patients
Conclusions
• Inter professional learning through a multidisciplinary approach to patient care improved collaboration between Nursing and Dietetics, raising the profile of nutrition and quality care
• Competency Based Assessment Evidence Guides for ward nutrition procedures, and a credentialing process to verify nurse competence, facilitated change in clinical practice through implementing evidence based practice
• The model of care is sustainable, can link to the NSQHS Standards, and be embedded as standard ward practice