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Community nutrition nurse specialist role: a service improvement

02 February 2020
Volume 25 · Issue 2


This article describes the introduction of a community nutrition specialist nurse role in Buckinghamshire. The need for this role arose from issues experienced by the large but busy district nursing team (caseload of >300 patients per day) in home enteral feeding management and troubleshooting. The post holder was appointed to support community, hospital, dietitians and industry home care nurses with nutritional screening in the community and home enteral feeding, with a greater focus on the former. The post holder was involved in the development of a community version of MUST along with a care pathway and the design of a training programme to improve district nurses' knowledge and confidence in managing malnutrition in the community. The post holder is also involved providing patients personalised advice for managing malnutrition and in referrals to the community dietetics team. Such innovations in staffing are vital if the negative impact of malnutrition on patients and the health service is to be curtailed.

It is well documented that there are 3 million people in the UK who are malnourished or at risk of malnourishment, and 93% of these individuals are in the community (BAPEN, 2018). The cost of malnutrition in England alone is estimated to be £19 billion per annum. Therefore, its early identification and management has the potential to improve quality of life and reduce the burden of spending in the NHS (Managing Adult Malnutrition, 2017). Malnutrition screening using a Malnutrition Universal Screening Tool (MUST) has long been the gold standard in identifying malnutrition (BAPEN, 2003; National Institute for Health and Care Excellence (NICE) 2012; Murphy et al 2018; Dera and Woodham, 2016). This tool is generally focused on screening patients in a hospital setting, and the actions and care plans are not appropriate for monitoring generally well patients. For example, screening in the community is needed only monthly or annually, whereas the recommendations for in an acute hospital setting are weekly screening.

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