Authors (including presenting author) :
HYT TING(1), WONG Chiyan(1), Able CHAN(2), TONG Mei Hoi(2), CHIM Chun King(2), TSANG Tsui Lin(2)
Affiliation :
1) Dietetics Department, North District Hospital 2) Community Outreach Service Team, North District Hospital
Introduction :
Post-discharge malnourished patients are often unable to sustain their prescribed hospital nutrition regime at the elder home. Elderly people with poor nutrition status are more prone to infection, poor wound healing, decreased cognitive function, reduced muscle strength, and increased acute hospital readmission. Community outreach care has been suggested to improve the nutritional well-being of the post-discharge malnourished patients at the extended care insititutions.
Objectives :
This review evaluates the effect of the North District Hospital post-discharge community outreach nutrition program on the malnourished patients, measured by the body weight and the nutrition intake.
Methodology :
From June 2016 to June 2018, 48 malnourished patients seen by the dietitians during their hospital stay were referred to the Community Outreach Services Team (COST) of the North District Hospital for post-discharge nutrition care. Two nutritional indicators, namely body weight change and nutritional intake, were compared at the baseline and after the COST intervention. Twenty-one body weight records were collected during the hospital stay and at the elderly home for comparison. For the nutrition intake, 19 records (energy and protein intakes) were collected at the first dietitian assessment and during the COST visit for comparison. Patients with fluid retention were excluded for the body weight analysis. Patients without the weight and oral intake records at either baseline or post-intervention were also excluded in this review.
Result & Outcome :
Fifteen out of 21 patients (71%) gained weight by the end of the program. The mean weight at the baseline and post-intervention were 40.0±8.93kg and 41.9±9.71kg respectively (p=0.253). All 19 patients improved in nutritional intake. Energy intake significantly increased by 52%, the baseline and post-intervention energy intake were 699±368.71Kcal and 1063±213.98Kcal respectively (p<0.01). Protein intake also improved significantly by 48%, the baseline and post-treatment protein intake were 29±12.72g and 43±12.96g (p<0.01). This service review demonstrated that community outreach service is promising in enhancing nutrition well-being of the post-discharged malnourished patients. Future evaluation can be focused on other clinical outcomes such as re-admission rate and mortality rate.
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