This page features information about three of our past projects ('OPEN Eastleigh Project', 'Nutrition Awareness in Community Pharmacies' and 'Food is a 'MUST''). A brief overview of each project has been provided, along with some of lessons learnt from them.
Older People's Essential Nutrition (OPEN) Eastleigh Project
The OPEN Eastleigh project was a quality improvement programme for malnourishment in older people; facilitating the implementation of NICE (CG32) and other national guidelines for nutritional support (screening, individualising care and documenting the nutritional support plan).
As part of the Nutrition in Older People Programme, a review was carried out in 2014 with dietetic and nutritional experts and interested parties from across Wessex to reach a better understanding of the reasons why the existing national guidelines for nutritional care were inconsistently implemented in the community setting. The OPEN initiative was designed to address these issues. The aim of OPEN were to develop and evaluate an approach for the provision of good nutritional care for older people within the community setting so that other areas across Wessex, and nationally, can use the learning and either replicate or adopt it in their local area and context. The approach built on an original pilot in Purbeck, which is part of the Dorset Malnutrition Prevention Programme, one of five national Malnutrition Taskforce Pilots, and part of the portfolio of projects supported by the Wessex AHSN Nutrition in Older People Programme.
OPEN was run in Eastleigh, Hampshire, and aimed to reduce the number of older people who are undernourished and the associated health and social care use. The initiative included:
The biggest challenges to implementation of evidence-based practice in nutritional care is the large number of organisations, teams, and individuals who need to commit to implementing integrated nutritional care pathways. The time and effort required should not be under-estimated. It is vital that the initiatives have local leadership to provide the drive and commitment for delivery. Engagement and commitment is needed at leadership and frontline levels.
Evaluation reports (including lessons learned from community integrated projects) for the OPEN Eastleigh project are available to download in the resources section. This project has also been featured in a recent Public Health England review, published in February 2017, entitled "Helping older people maintain a healthy diet: A review of what works". As part of our OPEN Toolkit, we have produced this guide to recognising undernutrition in older people. Please feel free to share and use this resource:
Nutrition Awareness in Community Pharmacies (Portsmouth)
In partnership with NHS Portsmouth CCG, Portsmouth City Council's Independence and Wellbeing Team and Portsmouth Dietitians, the Wessex AHSN carried out a project to explore the feasibility of community pharmacies in raising awareness of undernutrition in older people, and assess whether providing training to pharmacy staff led to improved awareness of undernutrition and specific conversations with older people. Following training, staff from four community pharmacies in Portsmouth carried out a three-month initiative involving talking to older people about their weight, recent weight loss and eating habits using a structured questionnaire. As part of the conversation, they then provided some basic information, signposting and resources to help support people to maintain a healthy weight. We have produced an evaluation report and poster for this work, which are available to download from the 'resources' section.
Key lessons learnt from this project include:
In South Wiltshire, a care home pilot was carried out, which provided more intensive support to care home team following training, based on written agreement between the dietitians and the care home management to meet the objectives of the project. A follow up review and visit one month post-implementation showed that training and use of documentation enabled the care home staff to develop effective care plans which met best practice recommendations for identifying and managing malnutrition.
The FiaM project is currently being re-evaluated and more information will be uploaded in due course. For more information about the project, please view the FiaM poster and presentations slides from the Wessex AHSN 2015 conference, which can be found in the 'resources' section on this page.