patients was re-audited 6 months after the introduction of the late evening snack round to evaluate its impact. Carbohydrate content of food and drink were analysed using manufacturer's labels or a carbohydrate database . The audit included 26 participant contacts pre and post-snack round. After introducing a late evening snack round the number of participants consuming !50g of carbohydrate increased, however, 50% still did not achieve this target. The mean total carbohydrate intake more than doubled and the number of participants consuming carbohydrate increased from 50 to 96%. The number of participants taking oral nutritional supplements increased, which contributed to total carbohydrate intake but did not significantly alter the number of participant consuming carbohydrate. This audit supports the practice of a late evening snack round on all hepatology wards as the total number of participants consuming carbohydrate and mean carbohydrate intake increased considerably. However, only 50% achieved !50g of carbohydrate, demonstrating that clinical guidelines can be challenging to implement in practice. Further work will focus on educating ward staff regarding what constitutes 50g of carbohydrate and how they can help patients to achieve this.
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