Improving nutritional screening of patients aged over 75 years admitted to internal medicine wards: a best practice implementation project

ABSTRACT Introduction: Malnutrition, resulting from insufficient nutritional intake or poor dietary choices, significantly affects hospitalized patients, leading to longer hospital stays and increased health care costs. The European Nutrition for Health Alliance and subsequent initiatives have emphasized the importance of nutritional screening. Objectives: This study aimed to improve nutritional screening among patients aged over 75 years admitted to internal medicine wards by assessing compliance with best practices and identifying and addressing barriers to effective implementation of recommended practices. Methods: Using the JBI Evidence Implementation Framework, the project involved a structured audit and feedback process across seven phases. Baseline audit data were collected from all patients aged over 75 years admitted to internal medicine wards over 1 month. The JBI Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) audit and feedback tools were used to identify barriers and develop strategies to address them. A follow-up audit was conducted 6 months post-implementation to measure changes in compliance with recommended practices. Results: The follow-up audit showed a significant improvement in compliance with best practices, which increased from 22.62% at baseline to 48.26%, reflecting the effectiveness of the targeted interventions. Nurses reported enhanced knowledge and confidence in conducting screenings, although gaps in documentation practices remained. Conclusion: This project successfully improved compliance with nutritional screening practices, highlighting the importance of stakeholder engagement, training, and support. Future efforts should focus on sustaining these improvements through enhanced training and interdisciplinary collaboration, with the aim of improving the outcomes of patients at risk of malnutrition. Spanish abstract: http://links.lww.com/IJEBH/A521