Manage Abstracts

Among newly admitted patients to Community Home Health (HH), a total of 64% are malnourished or at risk of malnutrition. Routine nutrition screening and timely follow up by Registered Dietitians (RDs) can reduce length of stay and complications in acute care.

To examine whether the implementation of the Mini-Nutritional Assessment (MNA®) done by HH clinicians leads to an increase of patient referrals and more timely referrals to HH RDs. To explore clinicians’ and the manager’s experiences with respect to the MNA® application in the community setting.

Quantitative retrospective data analyzed tabulating the number of referrals made to the RD and time from admission to HH and date of referral to RD during two 6-month periods: pre-intervention and MNA® intervention at Evergreen Community Health Centre in Vancouver. Post intervention, a focus group was conducted with the manager and 5 HH clinicians to assess tool acceptability. A time control group at another health unit that did not receive the intervention was also assessed.

With the MNA® intervention, the referral rate to the RD increased from 4.6% to 8.4% (p=0.002) but no change in the time to referral (p=0.75). In the control group, referral rate change was insignificant (p=0.200) and increase in referral time (p=0.08) was significant hypothesizing that the absence of the MNA® may increase referral times to the RD. Enablers of the screening tool included important knowledge gained and increased patient satisfaction. Barriers included need for further BMI education, limited RD resources, and additional weighing scales required.

Use of the MNA® was associated with increased referrals to the HH RD. Although clinicians and clients found the MNA® easy to use, further education on BMI calculations, increased RD resources, and additional weighing scales are needed.

Routine screening using MNA® in HH community to make appropriate referrals to the RD is recommended.