Preimplementation of malnutrition screening in the context of outpatient memory care: A quality improvement project

Older adults with dementia are at heightened risk of malnutrition, but nutrition screening is an uncommon practice in this population. This study aimed to determine the feasibility of malnutrition screening and to determine nutrition risk prevalence in an outpatient memory care clinic.

This quality improvement project used the eight-item Seniors in the Community: Risk Evaluation for Eating and Nutrition screener to determine nutrition risk. The Organizational Readiness to Change Assessment (ORCA) determined providers' views on readiness for change.

During the 12-week trial, 15.3% of eligible memory care clinic patients were screened. Of these, 58.3% (n = 123) had high nutrition risk. Lack of staffing was the most significant barrier to completion of nutrition screening. Clinic staff responses on the ORCA indicated moderate agreement that screening among persons with dementia is evidence based (mean = 3.7 of 5; SD = 0.26) and strong agreement for evidence of organizational support (mean = 4.12 of 5; SD = 0.38). A majority of patients and/or caregivers reported nutrition screening was easy (n = 79 of 211) or extremely easy (n = 44 of 211). A total of 69 patients (33.7%) who completed the screener indicated interest in a nutrition consultation. The most common barriers to nutrition services reported by caregivers and/or patients were difficulty accessing the clinic and unwillingness to use nutrition services.

This study detected barriers and facilitators to administering nutrition screening in a memory care clinic. These preliminary findings suggest further efforts to implement nutrition screening in outpatient memory care clinics are warranted.