Mr Cameron Mclean1,2, Ms Natasha Turner1, Ms Helen Dragicevich1, Mr Terry Stefanidis1, Ms Chona Lauzon1, Ms Fauzia Haque1, Ms Claire Campbell2
1St George Hospital, Kogarah, Australia, 2University of Wollongong, Wollongong, Australia
Background: older adults at risk of malnutrition admitted to hospital may not be identified through routine referral pathways. The dietitian assistant workforce is underutilised in the management of nutrition risk screening and simple nutritional interventions. Aim: to implement and evaluate a structured dietitian assistant lead approach to nutrition risk screening and management of patients admitted to a Sydney Metropolitan Hospital aged care ward. Method: a dietitian assistant nutritional management pathway was trialed in October 2020 for 4 weeks. Patients were delegated to the dietitian assistant to screen and implement nutritional strategies. Descriptive characteristics, nutrition impact symptoms, change in menu ordering practices and oral intake were collected and descriptively analysed. Staff were surveyed pre and post implementation. Results: during the trial period 22 patients were seen on 40 occasions. The sample was mostly male (55%) with an average length of stay 16.1 days (range 4.8 – 43.5). 7 patients reported weight loss prior to hospital presentation. 15 patients would not have been identified through existing screening practices. Between initial contact and first review a clinically meaningful 100 kcal and 5 g protein intake increase was observed at a main meal. The number of patients ordering under targeted daily thresholds reduced from 55 % to 10 %. Staff reported the project contributed to meaningful patient care. Conclusion: a dietitian assistant management pathway contributes to greater scope of practice for the dietitian assistant and improved job satisfaction. Closer monitoring of oral intake and food preferences has contributed to meaningful improvements in oral intake.
Cameron McLean is an Accredited Practising Dietitian and Dietitian Assistant Educator at St George Hospital in Sydney. He is heavily involved in the clinical skill development of our Dietitian Assistant workforce and has a passion for quality and research activities.