Malnutrition in community-dwelling older people: lessons learnt using a new procedure

Abstract

This article reports the implementation of a new procedure for screening and treatment of malnutrition in a community NHS trust in England. The barriers and facilitators to implementation were assessed with staff from Integrated Community and Older People's Mental Health teams. Data from interviews and surveys were collected at baseline, 2 months after initial training and 16 months after initial training as well as following deployment of a nutrition lead to embed new developments for nutritional care. The adoption of the procedure made screening and treatment of malnutrition simpler and more likely to be actioned. The benefit of a nutrition lead and local nutrition champions to support and empower staff (avoiding reliance on training alone) was shown to drive change for nutritional care across the community. Prioritisation and commitment of leadership at the organisational level are needed to embed and sustain malnutrition screening and treatment in routine practice.

Prevention, identification and management of malnutrition in older people in the community

“…Despite these national recommendations, there are challenges associated with the use of the MUST by healthcare professionals in the community, including limited time to undertake the process, low prioritisation of nutrition, lack of ease in using certain aspects of the tool, lack of nutritional knowledge and assessment skills, lack of suitable equipment such as weighing scales and lack of training in malnutrition screening (Bracher et al 2019, Harris et al 2019. Embedding and sustaining malnutrition screening and treatment in routine practice requires senior leadership teams to prioritise and commit to nutritional care (Murphy et al 2020a). NICE (2017) guidelines do not specify the timing and frequency of malnutrition screening for older people living at home, and healthcare organisations should have local policies that cover this.…”