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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024OP-11Improving Nutritional Status among Bedridden Patients on Enteral Feeding inDomiciliary Services: Perlis InitiativeNoorhayati MY1, Syadzwa AH2, Syamimi S3, Nurasmilla MN4, Afidayati A5, Sofeah AR5, Jasmani MJ51 Klinik Kesihatan Kampung Gial, Arau, Perlis2 Pejabat Kesihatan Daerah Kangar, Perlis3 Klinik Kesihatan Pauh, Arau, Perlis4 Klinik Kesihatan Arau, Arau, Perlis5 Unit Domisiliari, Pejabat Kesihatan Daerah Kangar, PerlisSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Nutritional assessment is necessary to identify the risk of malnutrition among domiciliary care patients.Data from 2022 showed that 68% of bedridden on enteral feeding patients in Perlis domiciliary carepresented with malnutrition. Malnutrition left untreated can have fatal consequences, including a highinfection rate and poor wound healing.KEY MEASURES FOR IMPROVEMENT:The indicator used was percentage of malnutrition among bedridden patients on enteral feeding indomiciliary care assessed using Mini Nutrition Assessment form. The standard of <30% was set based onthe National Health Morbidity Survey 2018.PROCESS OF GATHERING INFORMATION:A cross-sectional study was conducted in two-consecutive phases using universal sampling involving 101bedridden patients on enteral feeding registered under Perlis domiciliary care in 2022. The sampling toolswere patient%u2019s record book, knowledge assessment of caretakers and observational checklist on EnteralNutrition Formula (ENF) preparation by caretakers.ANALYSIS AND INTERPRETATION:The baseline data from the verification study in 2022 was 68%. The main contributing factors wereunaffordable ENF (55.1%), lack of knowledge on enteral feeding (21.7%) and incorrect ENF preparationtechnique (11.6%).STRATEGIES FOR CHANGE:Remedial measures included suggestions for cheaper ENF alternative, standardised infographic ENFprescription and patient homecare management course to caretakers. In addition, we introducedblenderized tube feeding (Complete Nutrition; Gastro Ease and Elate - CoNGEE) as an option ofnutritional support for caretakers who cannot afford to purchase ENF.EFFECT OF CHANGE:The percentage was decreased from 68% to 51.5% in cycle 1. Upon implementing the CoNGEEalternative, further reduction to 14.9% was achieved, exceeding the standard set of <30%. AchievableBenefit Not Achieved was improved from 38% to 21.5% and finally %u201315.1%.THE NEXT STEP:We will implement the guideline and training module at the state level. The CoNGEE nutritionalinformation will be further validated for precise nutrition content. We aim to have our CoNGEE projectfor nationwide replication to benefit homecare bedridden patients with financial limitations in obtainingtotal nutritional intake.36 | Page