Background and Context:
: Weight loss is an indicator of poor prognosis in cancer patients. Up to fifty percent of cancer patients are at risk for malnutrition. (Current Oncology (2012). 19(5), 305–7). Early intervention of malnutrition may also decelerate or prevent progression to cachexia. (J Cachexia Sarcopenia Muscle (2011). 2, 27-35
Aim:
To implement a valid and reliable screening tool that oncology health professionals could use to assess a patient’s risk for malnutrition thereby improving patient outcomes. To establish roles and responsibilities for dietitians and nurses in the screening and assessment of malnutrition in oncology patients
Strategy/Tactics:
A valid screening tool, the Malnutrition Screening Tool (MST) was identified from the research literature. Once identified, a small team from the Nursing and Nutrition departments at the Kuwait Cancer Control Center (KCCC) was formed to design a two month trial using the MST to assess and determine the malnutrition risk for patients admitted to KCCC’s medical wards.
Programme/Policy Process:
The interprofessional team developed a project charter, screening procedure, forms, educational materials and evaluation tools to support the trial. The nurses and dietitians on the pilot wards received education about the tool and the trial process. The pilot was evaluated through a chart audit, focus groups and survey of trial participants.
Outcomes/What was learned:
Evaluation data demonstrated that 47% of patients screened had an MST score identifying them as at risk for malnutrition. This finding coincides with the literature stating that up to 50% of cancer patients are at risk for malnutrition. The implementation of the MST was therefore effective in early identification of a previously under-reported problem. The data further demonstrated that routine screening promotes: earlier detection of a patient’s malnutrition risk; improved communication and collaboration between dietitians and nurses; and prioritization of patients requiring further nutritional assessment.