Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
Staff Engagement and Empowerment (motivating staff / teamwork / work revamp tackling manpower issue / staff wellness / OSH / retention)
Authors (including presenting author) :
Lee WL (1), WOO Mimy (2), Lee TC Alex (1), Wong KL (1), Lam HS (1)
Affiliation :
(1) Department of Medicine and Rehabilitation, Tung Wah Eastern Hospital(TWEH) (2) Department of Dietetics, Tung Wah Eastern Hospital(TWEH)
Introduction :
Malnutrition are highly prevalent in elderly persons with dementia during hospitalization. It is correlated with a worse prognosis and causes negative impact on quality of life. Mealtime intervention and multi-dimensional intervention was found to be significant in improving malnutrition. The ward current practice did not involve multidiscipline approach in nutrition improvement which might result in fair feeding compliance. Therefore, a nutrition enhancement program was designed to confer improvements in patients with poor oral intake.
Objectives :
Aim: To improve elderly patients’ oral intake by interdisciplinary approach which involves case doctor, nurses, dietitians, speech therapists, clinical psychologist and family members. Objective: 1. To design and implement Nutrition enhancement workflow for enhancement feeding practice. 2. To design and implement oral supplement reminder and scheduled meal intervention in ward practice to increase ward awareness on importance of supplement feeding. 3. To design and implement ‘list of seasoning’ according to the health condition with collaboration with dietitians.
Methodology :
A pilot study was implemented in rehabilitation ward from May to December 2023. Elderly patients aged over 65 years-old diagnosed with dementia and HKC-MUST >1 were recruited. A workflow with interdisciplinary team approach for poor oral intake patients was designed and adopted. Briefing sessions were held to all rehabilitation nurses to align the practices. Family members was facilitated to provide individualized meal regime catering patients’ needs and preference with reference to advice from speech therapists and dietitians to promote food enjoyment. Patients’ mood was accessed and proper referral to clinical psychologist had been made for psychological intervention when in needs. Diet restriction was reviewed by physicians to improve oral appetite. For ward practice, oral supplement reminder with scheduled time had been designed for reminding patient care assistants. Ward routine had been modified to enhance supplement compliance. Proper documentation in oral intake had been reinforced. Designated nurses were assigned to supervise the routine compliance.
Result & Outcome :
Results:
Total 25 patients were recruited in the program. 4 of which with geriatric depression score >7 /15 was referred to clinical psychologist. Pre and post intake (ml) was compared. Average increase 150ml in daily oral intake. Besides, satisfaction survey was conducted and appreciation to our seasoning list was received from 20 cases’ family.
Conclusions:
To conclude, the positive result on enhancement reflects the importance of interdisciplinary approach and family in oral intake. The seasoning list effectively encourage family involvement and enhance patients’ intake. The quality of care and close communication amongst patients/family together with the health care team could be sustained
