Abstract
Introduction
The importance of nutritional support has been extensively investigated in studies of people with hip and fragility fractures. Hospital nutritional assessments vary in quality, and this limits the extent to which risk assessment can be viewed as a meaningful indicator of nutritional support. Provision of supplements is an alternative measure, but only if known to have been consumed. For this reason, we developed a protocol to capture actual consumption of prescribed supplements. Methods Following nutritional risk assessment, the prescription and distribution of supplements was recorded on patients’ drug charts in the usual way. Our protocol required that when supplement cups were cleared, nurses should annotate the drug chart with the volume of supplement each patient had actually consumed. Following this protocol’s introduction, we conducted a point prevalence survey of patients’ supplement consumption in orthogeriatric rehabilitation wards in May 2024. Results Of 25 inpatients with hip fracture, 21 (84%) had been identified as being at nutritional risk and prescribed Fortisip compact protein. Patients were recorded to have consumed between 50 and 100% of the supplement. This quantification of actual consumption allowed us to calculate that, on average, these patients with hip fracture had consumed an average of 188ml/day — which would provide an additional daily 27.4g of protein and 460 kcal of energy. Figures for 15 patients with other forms of orthopaedic injury indicated that 8 (53%) were at risk. These patients recorded similar levels of supplement consumption. Conclusion The prevalence of nutritional risk and malnutrition among patients with hip fracture would suggest that all should be considered ‘at risk’. A performance indicator might be constructed which starts with this assumption and measures whether such patients have actually consumed nutritional supplements. Our simple approach captures actual consumption, whilst reminding us of the importance of nutrition.