An Appetite For Change Purbeck Sue Hawkins Care Catering Services Manager Michelle Smith Health Programme Advisor Dorset's Nutritional Care Strategy for.

An Appetite For ChangePurbeck

Sue HawkinsCare Catering Services Manager

Michelle SmithHealth Programme Advisor

Dorset's Nutritional Care Strategy for Adults supported by:

Dorset’s Reaction

• Nutritional Care Strategy For Adults • Care Pathways:

• Raising awareness• The Home and The Community• Care and Nursing Homes• Community Hospitals• Community Hospital Discharge Planning• Acute Hospitals• Acute Hospital Discharge Planning• GP Practice


Malnutrition Universal Screening Tool

MUST

3 Steps:Step 1 = BMI score 0,1 or 2Step 2 = Weight loss Score 0,1 or 2Step 3 = Acute Disease Effect 2TOTAL = MUST score Maximum 6!

Step 3 – not generally used in the Community


Screening Questions

Is the Person Very Underweight?• Prominence of bones, ribs, muscle wasting

Has the person lost weight unintentionally?• Fit/size of clothes• Watch straps/wedding rings• 10% of body weight – 10 stone now 9 stone



Wellbridge Practice Locality Pilot

• Joint working – 68 staff involved• GP Practice Nurses• Purbeck Locality Team• Purbeck Integrated Team• OT’s/Physio’s• Social Workers• Community Matron and Staff Nurses• Falls Assistant• Re-ablement Team• Carers Caseworker• Adults Safeguarding Triage Team• Community Stroke Practitioner

If starting to be concerned

Build Yourself Up• Introduction on Malnutrition and Dehydration• How to increase calories and proteins• What if I’ve lost my appetite or am too tired • Sample Menu Plan• Nourishing Drinks• Foods to keep in the cupboards• Assisting someone to eat• Hydration• Eating Opportunities



Or not?

Evaluation

• Process only • Training, Care Pathways, Administration, General operational issues• Individual questionnaires and focus groups with each participating

team through existing team meetings


Training

• 100% of respondents felt the session met it’s objectives• 78% stated that their knowledge of malnutrition had increased • 100% of delegates had a better understanding for their role in

delivering nutritional screening and everyone felt confident to return to their day jobs and start screening


Focus Groups

Several staff stated they could see the need and value in nutritional screening and that they understood their role in it; and the need for the prevention of malnutrition in the community.

The paperwork was generally manageable within their existing roles and the pathways were easy to follow

Time needed for paperwork was too much so would benefit from being reduced

Sharing data across teams was problematic. The scales that were provided were not appropriate for use.


Room for Improvement

Forms need to be amended to make them shorter Effort needs to be made to engage the Mental Health Team The pathway needs to include a signposting option for staff if they

identify a service user who they are concerned is overweight. An IT system that will allow the sharing of data across and within

organisations and that allows staff to complete the forms electronically on site needs to be explored to avoid duplication reduce admin time.

Alternative scales need to be sourced An option for wheel chair users to be weighed needs to be explored

All of the above have done been addressed


Next Steps - Purbeck and Beyond…..

Purbeck GP Locality engaged ( further 5 GP practices) Electronic forms and mobile IT options needs to be set up Launch to tell the Purbeck locality about the programme - TODAY Wider Purbeck staff need to trained – Oct / Nov 2013 Evaluation framework for the wider pilot needs to be established with

Solent University so we can also begin to evaluate whether we are actually making a difference to the health and well being of people in Purbeck and to measure any potential cost savings made as a result of the screening programme

Build a case for a roll out to the whole of Dorset - need your help to do this! More evaluation!


Any Questions?

Contacts:

Sue Hawkins Michelle [email protected] [email protected]

01305 225930 Strategy - www.dorsetforyou.com/nutritional-care-strategy

Care Pathways- www.dorsetforyou.com/nutritional-care-strategyBuild Yourself Up - www.dorsetforyou.com/407934

Eating Opportunities - www.dorsetforyou.com/eatingopportunities


mailto:[email protected]



An Appetite For Change Purbeck Sue Hawkins Care Catering Services Manager Michelle Smith Health Programme Advisor Dorset's Nutritional Care Strategy for.

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