P-28: The More-2-Eat Project: Key nutrition care changes in hospitals implementing the INPAC pathway
Valaitis, R.*, Laur, C., McNicholl, T., Keller, H.
University of Waterloo
Background/Objectives: The More-2-Eat project aims to optimize nutrition care in 5 Canadian hospital units through the implementation of the Integrated Nutrition Pathway for Acute Care (INPAC). Hospitals spent one year making positive changes to nutrition care processes, including malnutrition screening, nutrition risk assessment [Subjective Global Assessment (SGA)], food intake monitoring, standard/advanced care strategies and discharge planning.
Methods: Hospital staff collected data from patient health records (N=3,838) to track routine nutrition care activities on the unit. Detailed patient data was collected on approximately 20 patients per month to track patientsâ€™ health and nutritional status and barriers to food intake (N=1,007). Each month, sites received feedback reports to track their progress to help stimulate and maintain positive change.
Results: All 5 sites increased the number of patients screened for malnutrition. By the end of implementation, sites were screening 66-89% of admitted patients. SGA was not used prior to implementation. Once introduced and promoted, the number of patients at nutrition-risk assessed using SGA ranged from 12 to 70 percent. Three sites worked towards implementing food intake monitoring using a variety of strategies. Monitoring that resulted in actions to improve intake increased from 19% to 54%, 4% to 93%, and 0 to 96% in those sites. Some sites were also able to reduce the average number of mealtime barriers identified by patients.
Conclusions: Using a variety of implementation strategies, all sites saw improvements in a range of INPAC activities. Sites are now focusing on sustainability and rolling out those changes in other units.
This research is funded by CFN (Canadian Frailty Network).