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The Nutrition Support Community Dietetics Team at the 5 Boroughs Partnership NHS Foundation Trust in North West England has utilised the malnutrition pathway materials as part of their ‘Nutrition Link Programme’.

The aim of this programme is to improve the quality of nutritional care for patients by providing training to care homes and in-patient ward representatives, who are referred to as ‘Links’.
‘Links’ are enlisted as a nutritional care lead, acting as a point of contact for staff to disseminate information and lead practical application of nutritional care in their setting.  It is hoped that improved standards of nutritional care will improve the quality of life of the patients and increased knowledge will contribute to promoting and encouraging appropriate prescribing and use of oral nutritional supplements.

The programme was implemented in care homes and in-patients rehab wards in community hospitals in St. Helens and Knowsley.  Education sessions were run in various venues across the area.

The programme began with a scoping meeting to correlate feedback from care homes and community wards on the type of education they would like to receive on malnutrition, in order to address any gaps in knowledge.  Based on this feedback, a series of eight education sessions were planned and these are now run on a quarterly basis, consisting of a two-year cycle.
Topics such as ‘Nutrition and Hydration in Dementia’, ‘Homemade Supplements and Menu Planning for Chefs’, ‘Enriching at Point of Care for Carers’, ‘Introduction to Dysphagia and Texture Modification’ and ‘Understanding Oral Nutritional Supplement Prescribing’ are examples of education sessions that have been run in the first year of the programme.

All care homes and community wards in the St. Helens and Knowsley area were invited to the quarterly sessions, which are then repeated according to demand.  The programme is also used to raise awareness of local nutritional guidelines and the training provided by the dietetic department. 

The ‘Managing Adult Malnutrition in the Community’ website and the videos were signposted as tools for training staff not present at the education sessions. Resources of particular use to the programme were the practical online tool for calculating percentage weight loss (an area which was identified by the ‘Links’ as often miscalculated or not understood), the ‘Managing Malnutrition using Risk Category according to ‘MUST’ information sheet and the patient information leaflets - ‘Making the most of your Food’ and ‘Nutrition Drinks: advice for patients and carers’ (links to be included to relevant sections).

Having these reference materials already produced and available to use free of charge allowed the programme to focus its resources on developing and providing the education sessions while still being able to provide the ‘Managing Adult Malnutrition in the Community’ guidance for written reference.

An evaluation form of approximately 20 questions was designed to gather information on current practices in the Links’ care settings. This evaluation aims to assess compliance to national guidance such as NICE guidance, NICE quality standards and CQC outcomes. This evaluation will be repeated six monthly throughout the course of the project to determine if involvement in the programme has increased compliance to these standards.

At each education session participants are asked for feedback on ‘what they found useful / liked about the session’ and ‘what they thought could have been done better / other information they would like’. This information is collected to inform the structure and operation of future sessions.
In the future the programme hopes to collect more qualitative data on the Links’ experience of being involved in the Nutrition Link Programme and how this has changed and improved practices within each care setting.

These outcome measures will be used to inform and shape the education provided in order to improve nutritional care standards and strive to increase compliance with national standards.

For further information on the project please contact:
The Nutrition Support Team
Community Dietetics Service
5 Boroughs Partnership NHS Foundation Trust,
Community Health Services,
Unit 4, Kings Business Park,
L34 1PJ


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