Mrs Kimberly Stramyk1
1Central Coast Local Health District (CCLHD), Gosford, Australia
Background: Patients who have dialysis have special nutritional needs. While admitted to hospital, it is recommended that dialysis patients have a high protein, no-added salt diet with mindfulness towards the risk of fluid overload. It was identified that many dialysis patients were not ordered appropriate therapeutic diet types when they were admitted to hospital, which could result in increased risk of morbidity and length of stay.
Methods: An audit of therapeutic diet ordering was undertaken from June to August of 2020, the results of which identified that only 32.5% (13 of 40 patients) of dialysis patients admitted for ≥24 hours were ordered an appropriate therapeutic diet during their admission, and fluid restriction was only ordered for 50% (n=20) of these patients. To address this concern, the renal dietitian created and implemented a ‘Dunny Dit,’ which is a simple A4 poster placed in staff bathrooms on the hospital wards, outlining the diet and fluid recommendations for dialysis patients, their rationale and where to go for more information.
Results: A repeat audit conducted from November 2020 to January 2021 after implementation of the Dunny Dit demonstrated an improvement of 34.2% in the proportion of patients who were ordered an appropriate therapeutic diet (66.7%, 22 of 33 patients), and a 13.6% improvement in the proportion of patients ordered a fluid restriction (63.6%, n=21).
Conclusions: Bathroom posters present a unique opportunity to provide education to nurses that can result in meaningful changes to adherence to multidisciplinary recommendations.
Kim is a clinical dietitian for the Central Coast Local Health District (CCLHD), working in the renal specialty. Kim graduated from the University of Newcastle in 2014 with a Bachelor of Nutrition & Dietetics with Honours Class I, and has worked in generalist roles, as well as Diabetes and Renal specialty roles.