Food For Thought: Evaluation of malnutrition risk identification & management at Western Health

Ms Hollie Bevans1, Mrs Karon Markovski1, Mrs Aranka Nenov1, Mr  Michael Wassertheil2, Ms Clare Black2, Ms Joanne Kwok2, Ms Bianca Trajcevski2, Ms Jemma Ginsburg2, Ms Bianca Woger2

1Western Health, Sunshine, Australia, 2Deakin University, Burwood, Australia


Aims: Malnutrition is a well recognised issue, however few patients receive appropriate nutrition treatment. With one in two inpatients at risk, Western Health has established a Nutrition Procedure to identify and manage malnutrition risk. The aims were to: assess completion and accuracy of the Malnutrition Screening Tool (MST) and compliance with the MST action plan; and assess adequacy of High Energy and Protein (HEHP) diet in meeting the needs of patients at risk.

Methods: Mixed methodology used. Retrospective audits of MST completion, accuracy and action plan compliance. Prospective audits of plate wastage and nutritional adequacy of meals and mid-meals for patients on a HEHP diet. Thematic analysis of patient surveys analysed awareness of malnutrition risk and HEHP diet and barriers to consumption of mid-meal items.

Results:  423 participants.  MST completion rates 91%, however only 41% accurate. Compliance with MST action plan 70%, however impacted by MST inaccuracy.

HEHP meal wastage was 34%, and provided patients with 66% of estimated energy and protein requirements. Mid-meal snacks were often not delivered (41%) or incorrect (50%). Main barriers were nausea (32%), anorexia (14%) or needing assistance. Patients’ awareness of MST risk and HEHP diet was only seen in patients under dietetic care.

Significance of the findings to allied health: Allied Health have a pivotal role in engagement and education of key stakeholders, including nursing and food services staff, to ensure successful, sustainable and effective implementation of organisational wide procedures.


Hollie is a senior dietitian currently working at Western Health. She has completed a Bachelor of Science, a Masters of Nutrition & Dietetics and a Master of Public Health. She has almost 20 years clinical experience, with an interest and expertise in the oncology field. She has been involved in many research and quality activities across her career.