Abstract
Introduction
Malnutrition is common in patients with hip fractures. Early post-operative ONS (oral nutritional supplements) have been shown to reduce the length of stay in hospital and improve post-operative outcomes. The aim of this audit is to determine the number of people within the Royal Victoria Hospital Fracture Unit with NOF (neck of femur) fractures who are receiving ONS; it also determined the reasons for doses missed. Additionally, it covers if baseline refeeding bloods were done as per Trust Guidelines.
Method
A two cycle audit was completed on the use of ONS in patients with NOF fractures in the Royal Victoria Hospital Fracture Unit. Data from 29 patients in the first audit and 30 patients in the re-audit was analysed. The amount of people who had ONS prescribed, the amount of doses they received, and the reasons doses were missed were recorded. The data was collected, analysed, and the following interventions were put in place. Reviewing ONS compliance with each patient in the standard day 1 and day 4 post-operative reviews commenced. The medical team were informed that baseline refeeding bloods (bone profile and magnesium) should be done on admission.
Results
From the first cycle to the second cycle, the number of patients getting refeeding bloods within 3 days of admission increased from 20.1% to 56.7%. The proportion of patients who missed ≤ 25% of doses of ONS increased from 38% to 76%. The number of doses missed per patient due to refusal dropped from 1.1 to 0.6.
Conclusion
To conclude, ONS have been proven to help reduce post-operative complications and improve rehabilitation. Integration of ONS as a part of the post-op review process should be highly encouraged. This gives a standardised way for the department to ensure compliance with the guidelines.