19AUDIT OF NUTRITIONAL INTAKE IN PATIENTS WITH HIP FRACTURE PRE AND POST AN INTERVENTION PROGRAMME TO ASSIST WITH FEEDING

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Abstract

Introduction: Malnutrition contributes to poor recovery from a hip fracture. Feeding difficulty is recognised as a common problem for older patients and is associated with malnutrition [1]. Some patients need complex nutritional support, but most simply need encouragement and assistance to enable them to eat properly [2]. Staff in busy trauma wards may find it difficult to spend adequate time with patients who need mealtime assistance.

Change strategies: An initial audit of daily energy and protein intake in post-operative patients with hip fracture was conducted on our Hip Fracture Unit (HFU).

A half-day induction and training session was organised for volunteers involving Specialist Dieticians, Consultant Orthogeriatrician, Hip Fracture Nurse Practitioner, Physiotherapists and Occupational Therapists. They attended the HFU daily to assist patients at high risk of malnutrition with feeding. A re-audit post-intervention was conducted.

Change effects: Fifteen patients (3 males and 12 females) pre-intervention, and 15 patients (1 male and 14 females) post-intervention were selected. Pre-intervention mean daily energy and protein intake on consecutive days were 1,441.4 kcal and 47.3 g, respectively. Post-intervention were 1,918.2 kcal and 71.5 g, respectively.

Energy and protein intake increased on average by 476.8 kcal (33%), 24.2 g (51%) with interventional feeding assistance.

Food record charts suggested 66% of assisted patients took nutritional supplements versus. 33% in the unassisted group.

No complications were highlighted. Patient and staff feedback were positive.

Conclusion: Energy and protein intake can be improved in post-operative patients with a volunteers intervention programme to assist with feeding. This strategy is worth considering in patients with a hip fracture to improve intake.

References:

1. Chang CC and Lin LC. Effects of a feeding skills training programme on nursing assistants and dementia patients. J Clin Nurs 2005

2. Duncan DG, Beck SJ, Hood K, Johansen A Using dietetic assistants to improve the outcome of hip fracture: a randomized-controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006

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