Background ‘IN REACH’ was established, having identified a significant need to improve nutrition for cognitively and physically frail hospital inpatients, admitted to the Complex Medical Units (CMU) at the John Radcliffe Hospital. The IN REACH team includes the CMU multi-disciplinary team (MDT), representatives from patient and volunteer groups, caterers and medical illustrators. Introduction IN REACH identified that food and drink is often unreachable by inpatients. The project’s aim is to ensure food and drink is always within patient reach, improving nutritional intake, avoiding dehydration, reducing weight loss, reducing family anxiety, promoting independence and improving health outcomes. Method MDT members, patients and their families were engaged in the design. Baseline observational data included whether both food and drink were in reach and whether the patient had cognitive impairment. Interventions to be evaluated by Plan-Do-Study-Act (PDSA) methodology include: Focussed education, presenting observational data to MDT and catering team; raising awareness at daily MDT meetings, emphasising shared responsibility. Prompting by signage, physical and digital. IN REACH Champions to be introduced. PDSA cycles 1 and 2 were completed. 3. and 4. are planned. Improved inpatient nutrition will be correlated with data on length of stay and health outcomes, monitored by repeat PDSA cycles. Improved rates of return to baseline function and independence are anticipated, by keeping food and drink, in reach. Results Out of 319 inpatients, 33% had both food and drink within reach. 67% had cognitive impairment; 73% of those were unable to reach their food and drink. Following PDSA cycles 1–2, 34% of patients had food and drink within reach, a negligible change. Conclusions Most CMU patients have food and drink left out of reach. Patients with cognitive impairment are particularly at risk. Changing ward culture is challenging. Further and repeated interventions are necessary.

中文翻译：

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2276 触手可及。这是每个人的责任。改善住院患者获得食物和饮料的机会。


背景 “IN REACH” 的成立是确定了改善认知和身体虚弱的医院住院患者的营养的重大需求，这些住院患者入住了约翰拉德克利夫医院的复杂医疗单位 （CMU）。IN REACH 团队包括 CMU 多学科团队 （MDT）、患者和志愿者团体的代表、餐饮服务商和医学插画师。简介 IN REACH 确定住院患者通常无法获得食物和饮料。该项目的目标是确保患者始终能够获得食物和饮料，提高营养摄入，避免脱水，减少体重减轻，减少家庭焦虑，促进独立和改善健康状况。方法 MDT 成员、患者及其家属参与了设计。基线观察数据包括食物和饮料是否触手可及以及患者是否有认知障碍。通过计划-执行-研究-行动 （PDSA） 方法评估的干预措施包括： 重点教育，向 MDT 和餐饮团队提供观察数据;在日常 MDT 会议上提高认识，强调共同责任。通过标牌、实体和数字提示。即将推出 REACH 冠军。PDSA 第 1 周期和第 2 周期已完成。3. 和 4.都是计划好的。住院营养的改善将与住院时间和健康结果的数据相关联，通过重复的 PDSA 周期进行监测。通过保持食物和饮料触手可及，预计会提高基线功能和独立性的恢复率。结果 在 319 名住院患者中，33% 的患者同时拥有食物和饮料。67% 有认知障碍;其中 73% 的人无法获得食物和饮料。在 PDSA 第 1-2 周期之后，34% 的患者可以吃到和喝，变化可以忽略不计。 结论 大多数 CMU 患者的食物和饮料都放在够不到的地方。认知障碍患者尤其面临风险。改变支会文化是具有挑战性的。进一步和反复的干预是必要的。