Comparing Nutrient Density of Raisins to Sports Chews

Patients admitted to our facility with a co-morbidity of malnutrition have a 42% chance of being readmitted within 30 days. Before, during, and after admission, poorly nourished patients can have associated adverse health effects that compound their acute illness. In order to improve quality care the dietitians enhanced the identification and diagnosis of these malnourished patients through an educational program targeted to physicians and nurses. The program included 1) Utilization of evidence-based practice guidelines (AND/ASPEN Clinical Characteristics Table) by dietitians and physicians to consistently and accurately identify malnourished patients; 2) Implementation of nursing in-services to improve malnutrition risk screening to encourage accurate documentation of oral intakes, timely completion of Braden assessments and empowerment to directly consult the dietitians; and 3) Development of a post-discharge plan that includes a 30 day supply of nutrition supplements and follow-up phone calls to at-risk patients. After implementation of this program, consults to dietitians for malnutrition have increased significantly. In addition, this program has increased the capturing and coding of the discharge diagnosis of Protein-Calorie Malnutrition by 18% and decreasing length of stay by 1.3 days, demonstrating successful education of the physicians and nurses for identifying possible at-risk patients and helping to increase reimbursement for these diagnosis related groups. Although post-discharge follow-up is still in progress, readmissions have already dropped from 42% to 31.1% in the first fewmonths of implementation. We will continue to pursue this program until readmissions have dropped to our goal of 10%.