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Nutrition support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition [CG32]

Measuring the use of this guidance

Recommendation: 1.1.4

All acute hospital trusts should have a multidisciplinary nutrition support team which may include: doctors (for example gastroenterologists, gastrointestinal surgeons, intensivists or others with a specific interest in nutrition support), dietitians, a specialist nutrition nurse, other nurses, pharmacists, biochemistry and microbiology laboratory support staff, and other allied healthcare professionals (for example, speech and language therapists).

What was measured: Hospitals that had a nutrition support team
Data collection end: December 2003
19%
Data collection end: December 2012
42%
Area covered: Local
Source: Adam JHT (2013) The development and evolution of nutrition service provision in the North East: 2003-2012. Gut, Vol 62, Suppl 1, p A204


Recommendation: 1.1.5

All hospital trusts should have a nutrition steering committee working within the clinical governance framework.

What was measured: Hospitals that had a nutrition steering committee
Data collection end: December 2003
31%
Data collection end: December 2007
94%
Area covered: Local
Source: Adam JHT (2013) The development and evolution of nutrition service provision in the North East: 2003-2012. Gut, Vol 62, Suppl 1, p A204


Recommendation: 1.2.2

All hospital inpatients on admission and all outpatients at their first clinic appointment should be screened. Screening should be repeated weekly for inpatients and when there is clinical concern for outpatients.

What was measured: Patients who had assessment of nutritional needs
Data collection end: June 2011
35%
Number that met the criteria: 129 / 368
Area covered: National
Source: NCEPOD - Measuring The Units

What was measured: Appropriate nutritional plan documented in notes
Data collection end: June 2011
52%
Number that met the criteria: 184 / 351
Area covered: National
Source: NCEPOD - Measuring The Units

What was measured: Patients who were screened for malnutrition on admission using MUST
72.9%
Number that met the criteria: 191 / 262
Area covered: Local
Source: Vincent RP et al. (2013). Adherence to the national institute of clinical excellence guidance on parenteral nutrition screening is not enough to improve outcomes. Clinical Nutrition, Vol 32, Issue 1, pp73-76.

What was measured: Proportion of outpatients screened for malnutrition
Data collection end: December 2003
15%
Data collection end: December 2012
33%
Area covered: Local
Source: Adam JHT (2013) The development and evolution of nutrition service provision in the North East: 2003-2012. Gut, Vol 62, Suppl 1, p A204

What was measured: Inpatients who had been screened using MUST
Data collection end: December 2011
55%
Number that met the criteria: 55 / 100
Data collection end: January 2012
73.33%
Number that met the criteria: 66 / 90
Area covered: Local
Source: Shah D et al (2013) Adult nutritional status assessment: Cross sectional follow up study in a united kingdom hospital. Gut, Vol 62, pA13

What was measured: Inpatients who had been screened using MUST
Data collection end: November 2012
36%
Number that met the criteria: / 28
Area covered: Local
Source: Tate DJ, Black C & Hollywood C (2013) Rapid and cost effective interventions in the nutritional management of patients at a large district general hospital lead to significant improvements in service and patient care. Gut, Vol 62 suppl 2 ,p A10


Recommendation: 1.2.6

Screening should assess body mass index (BMI) and percentage unintentional weight loss and should also consider the time over which nutrient intake has been unintentionally reduced and/or the likelihood of future impaired nutrient intake. The Malnutrition Universal Screening Tool (MUST), for example, may be used to do this.

What was measured: Proportion of patients admitted to a gastroenterology ward who had a completed screening for malnutrition on admission using The Malnutrition Universal Screening Tool (MUST).
Data collection end: November 2012
36%
Number that met the criteria: 10 / 28
Area covered: Local
Source: Tate DJ, Black C & Hollywood C (2013) Rapid and cost effective interventions in the nutritional management of patients at a large district general hospital lead to significant improvements in service and patient care. Gut, Vol 62 suppl 2 ,p A10



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