Sandra van Lill is a New Zealand Registered Dietitian specialising in nutrition for older people. Her current role is Advanced Clinician, Health of Older People at Middlemore. In addition to her clinical role Sandra is active in conducting research in malnutrition and nutrition screening specifically in orthogeriatrics. She was a founder member of SING (Special Interest Group for Nutrition in Gerontology, Dietitians New Zealand). She also consults for a number of Residential Aged Care Facilities in Auckland and played an active role in the development of the Dietitians New Zealand Menu Audit Tool.
Identifying and Managing Malnutrition on the Older Peoples Rehabilitation Ward
Malnutrition is common in older people and is associated with poorer outcomes e.g. failed rehabilitation, increased LOS and higher health care costs. Research at Middlemore Hospital in 2001, 2012 and 2020 found that over 50% of patients were malnourished or at-risk of malnutrition. Given that malnutrition is multifactorial in origin a proactive, interdisciplinary approach is essential to identifying and managing malnutrition.
This presentation describes: • How we successfully implemented e-Nutrition, a nutrition screening tool, to identify malnutrition on the geriatric wards at Middlemore Hospital. • An integrated, interdisciplinary strategy to manage malnutrition including: o Routine prescription of oral nutrition supplements for all hip fracture patients. o Dietitian nutrition intervention for all high risk patients. o Protected Meal Times and a Red Tray system. o Breakfast Group to assess patients’ functional status. o Adding malnutrition as a diagnosis on the discharge summary. o Inclusion of nutrition into patients’ rehab goals.
Take home messages • Nutrition is everyone’s concern, and an integrated interdisciplinary team approach is essential to identify and target malnutrition on the geriatric rehabilitation ward. • The Dietitian is a key member of the interdisciplinary team, and should provide tailored nutrition interventions to patients identified as at increased nutrition risk.
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