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Insights from a retrospective chart audit of oral nutrition supplement use in long-term care

Shanthi Johnsona, Roseann Nasser, Cherith L. McGregorb,, Krista R. Sawatzkyb,Kimberly T. Thieub, Sharon Walkerb, Jean Colemanb,

Background: Prescribing oral nutritional supplements (ONS) in long-term care (LTC) has steadily increased over time. This study aimed to develop insight into ONS use and prescription practices from a retrospective chart audit in LTC.

Methods: A standard tool collected data on background/demographics, nutritional assessment, intervention and monitoring information. A chart audit was conducted on 38 residents prescribed with ONS in 4 LTC homes.

Results: In 68% (n =25/38) of the charts, researchers were able to determine whether residents received ONS daily. Ninety-six percent (n= 24/25) received ONS on a daily basis. In 13% (5/38) of the charts, weight loss, poor appetite, and/or blood glucose control were indications for ONS. In 21% (n= 8/38), there were attempts to increase caloric intake using food and/or fortified foods. Of the charts reviewed, 84% (n= 32/38) had documentation of monitoring (eg, weight, dietary intake) and of these, 72% (n= 23/32) had documentation done annually. Only 34% (13/38) of the charts had prescriber information and the most common prescriber of ONS were physicians (85%, n= 11/13).

Conclusions: There is limited information collected regarding ONS use and prescribing practices are inconsistent. Guidelines, policies, and education are required to support ONS practice in LTC homes and should involve dietitians.