Aims: To pilot and evaluate the effectiveness of a new malnutrition screening, referral, assessment and treatment strategy for Peter Mac ambulatory radiotherapy patients in order to address the issue of cancer malnutrition, enhance nutrition services and improve patient care

Methods: A retrospective comparison of 318 new radiotherapy patients pre-and 324 patients post-implementation of the strategy across three Peter Mac radiotherapy sites. Data was collected on nutrition screening, weighing and referral practices at initial nursing assessment, and dietitian’s nutrition assessment and treatment practices. Implementation of the strategy involved development of a triage system for dietetic referral post screening based on Malnutrition Screening Tool (MST) score, establishing weighing stations, and training for nursing staff on the MST, weighing practices and new referral processes. Dietitians were trained on the new assessment and treatment processes. Pre-and post-implementation data were compared using descriptive statistics.

Results: Post implementation there was an improvement in malnutrition screening and the proportion of patients being weighed at initial assessment (18% vs. 53%; 31% vs. 61%, respectively). There was a small increase in the number of referrals made from 13% at baseline to 17% post-implementation, with an increase in the percentage of referrals from medical and allied health staff (7% vs. 20%; 0% vs. 8%, respectively). Appropriate timing of nutrition assessment remained relatively constant (78% vs. 72%) whilst the proportion of patients being assessed in their final week of treatment remained high (93% vs. 98%).

Conclusions: The strategy improved malnutrition screening rates and weighing practices of ambulatory radiotherapy patients and potentially increased awareness of malnutrition risk with healthcare professionals in this patient group.  Nutrition assessment and management throughout treatment remained timely and appropriate. Further work is underway to establish strategies to promote sustainable practice and ongoing evaluation of the strategy.