# The effects of a dietitian‐supported multidisciplinary nutrition intervention on optimizing nutrition care in older patients with hip fracture and at nutrition risk—A quality improvement study

## TL;DR

This study shows that adding a dietitian to a hospital team improved nutrition care for older patients with hip fractures.

## Contribution

It demonstrates how dietitian-led quality improvement using the Model for Improvement can enhance nutrition outcomes in at-risk patients.

## Key findings

- 80% of patients met energy and protein requirements after the intervention, up from 22%.
- Nutrition risk screening documentation increased from 10% to 80%.
- Intake documentation improved from 30% to 100%.

## Abstract

A 1‐day cross‐sectional study at our hospital found that only 22% of patients with hip fractures at nutrition risk met their energy and protein requirements during hospitalization. This study aimed to test whether closer collaboration between a clinical dietitian and ward staff, guided by the Model for Improvement, could optimize nutrition care for hospitalized older patients with hip fractures at nutrition risk.

A dietitian was embedded to facilitate staff‐led enhancements in nutrition care at an orthopedic ward in from September to December 2024. Two Plan‐Do‐Study‐Act cycles were implemented. Cycle 1 focused on nutrition documentation. Cycle 2 targeted nutrition intake. The primary outcome was the proportion of patients meeting individual energy and protein requirements (≥80%). Secondary process indicators were (1) ≥80% of patients screened using Nutrition Risk Screening 2002, and (2) ≥80% of at‐risk patients with intake documented in the medical record. Preintervention data served as the baseline.

The primary outcome was achieved, with 80% (8 of 10) of patients meeting both energy and protein requirements, a significant improvement from 22% (2 of 9) at baseline (P < 0.05). Documentation of nutrition risk increased from 10% (1 of 10) to 80% (8 of 10) (P < 0.01), and intake documentation improved from 30% (3 of 10) to 100% (10 of 10) (P < 0.01).

This quality improvement study demonstrates that applying the Model for Improvement to integrate a clinical dietitian into ward practice strengthened interdisciplinary nutrition care and led to measurable gains in screening, documentation, and nutrition intake among older patients with hip fractures at nutrition risk.