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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024QLL-136Improving the Percentage of Patients Receiving Enteral Nutrition Product (ENP)within 24 Hours of Dietitian Prescription in Hospital Sultan Idris Shah, SerdangIrne J1, Wardatul I1, Siah PJ1, Siti Zafirah MR1, Nurliyana N2, Halimatun Saadiah S1, Roslinda MS1,Normawati AW1, Fatimah S11 Sultan Idris Shah Serdang Hospital, Selangor2 University of Putra Malaysia, SelangorSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Dietitians prescribe ENP to ensure patients receive sufficient nutrient intake. A verification study inMarch - June 2016 showed 59.3% of patients received ENP within 24 hours of dietitian prescriptions. Weaim to improve this percentage.KEY MEASURES FOR IMPROVEMENT:The key indicator is the percentage of patients receiving ENP within 24 hours of the dietitian'sprescription. The standard is %u2265 90%, based on consensus in Dietetic Clinical Meeting 2016.PROCESS OF GATHERING INFORMATION:A quality improvement study was conducted using universal sampling in three selected wards with acalculated sample size of 140 subjects. Data for indicator and contributing factors was collected using anaudit form in three cycles at hospital level from 2016-2018.ANALYSIS AND INTERPRETATION:Verification study showed 40.7% patients did not receive ENP within 24 hours of dietitian prescription.The contributing factors included the product not being served to patients (27.3%), ENP not indented(9.3%), product not collected from dietetic department (2.1%), indent not being processed (1.4%) andwrongly indented by staff (0.7%).STRATEGIES FOR CHANGE:The strategies were establishing a dietetic chart, provision of formatted dietetic boards, updating the workprocedure and conducting continuous nursing education. Additionally, the nursing reporting format wasupdated, encouraging hospital attendants to prepare the ENP, conducting bedside teaching for nurses andproviding bedside tagging.EFFECT OF CHANGE:The percentage increased from 59.3% to 85.4% in cycle 1, then improved to 95.0% in cycle 2 and 97.1%in cycle 3. The Achievable Benefit Not Achieved improved from 30.7% to 4.6%, -5% and finally -7.1%.We successfully reduced the mean duration from 34 hours to 12%u00be hours and maintained low complicationand mortality rate among patients.THE NEXT STEP:This study was expanded to all wards in the hospital and has been replicated in Selangor hospitals in2018-2019. The remedial measures have been shared throughout the country through conference,publication in Q Bulletin and webinar. Regular audits have been conducted to ensure sustainableachievement.225 | Page