March 28, 2023 6:17 pm
Christina Nash,Laura Forbes
Tackling Malnutrition at Vancouver Coastal Health: Implementation of Subjective Global Assessment (SGA)
Names, Organizational Affiliations, and Locations of all Authors
E. Cabrera1, T. Cividin2, J. Arqueza2, A. Kwok2, R. Hsu2, L. Goharian2, T. Yeh2, J. Koh3
1Vancouver Coastal Health, Richmond, BC, 2Vancouver Coastal Health, Vancouver, BC, 3Providence Health Care, Vancouver, BC
To implement the practice of SGA at three Vancouver Acute Care sites.
Objective(s)/Process or Summary of Content
We developed a SGA training program, using a Train-the-Trainer model. We developed resources and provided ongoing support for trainers and dietitians. Through the process, we engaged dietitians to ensure we met their education needs.
Method(s)/Systemic Approach Used
Pre- and post-surveys were used to evaluate the training. Additionally, chart audits were conducted to determine if SGA was incorporated into dietitian practice.
Eight dietitian trainers were recruited and 34 dietitians participated in the training. When asked to rate their skill level in performing SGA, 52% of dietitians rated themselves competent prior to the training. This increased to 73% after training. Eighty-two percent were confident/somewhat confident prior to the training. This increased to 100% after the training. Prior to training, 47% reported performing SGA on at least half of their patients. This increased to 100% following training. Chart audits were conducted on 170 charts and 75% had an SGA rating documented. The Train-the-Trainer model was an effective way to deliver dietitian education that can be sustained to meet future training and education needs.
We recommend this model to others who are planning to deliver dietitian education on performing SGA. We recommend engaging dietitian staff and the interdisciplinary team on SGA for ongoing awareness and sustainability of the program.
Significance to Dietetics
Malnutrition leads to negative patient outcomes, extended length of stay, and increased costs to the healthcare system. SGA, the gold standard for diagnosing malnutrition, is a simple, standardized, bedside method and identifies those who would benefit from specialized nutrition care by a dietitian. Ensuring dietitians are trained on how to perform SGA and are confident in doing so will lead to improved patient care and outcomes.
This project was supported by a PHC/VCH Knowledge Translation Challenge grant, funded by the Robert H.N. Ho Enhancing Patient Care Fund.
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