Clinical dietitian Atrium Health Charlotte, North Carolina
Identify interventions targeted at treating and preventing malnutrition in identified patients
Children and adolescents with oncologic diagnoses are at increased risk of presenting with and developing malnutrition due to disease processes and aggressive therapies. Due to the cyclic nature of cancer therapy, the identification of malnutrition can be easily missed and often leads to increased risk of morbidity and mortality. Proper nutrition is vital not only to metabolic and hormonal regulation but also with maintaining baseline physical function and encouraging expected growth velocity.
The purpose of this quality improvement (QI) project is to implement nutrition intervention strategies to decrease the severity of malnutrition risk for patients undergoing treatment. Process measures are to increase the accurate documentation of nutrition status by providers and increase the percentage of patients with a new diagnosis who receive a nutrition consult within 30 days of diagnosis.
A QI team consisting of dietitians, clinical nurses, and a nurse practitioner convened using the Model for Improvement as the QI framework. An aim statement, key driver diagram, and process flow map were completed. Rapid cycle PDSAs are being used to test change ideas with adaptations incorporated as needed for the wide variety of sub-specialized clinics within the project.
The measured goals for this project are to increase the percentage of patients whose malnutrition risk category improves to a better risk category, decrease the incidence of malnutrition, increase the accurate provider documentation of nutrition status, and increase the percentage of patients with a new diagnosis who receive a nutrition consult within 30 days of diagnosis.