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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024PP-13Improving Adherence Levels of Oral Nutrition Supplements (ONS) Intake amongHospitalised Geriatric Patients at Hospital Kuala LumpurJayvikramjit S1, Leow CW1, Baswamati B1, Zuliehaiza K1, Noor Ain AT1, Ayu A21Department of Dietetics and Food Service, Hospital Kuala Lumpur2Medical Department, Hospital Kuala LumpurSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:ONS is used as part of nutrition intervention among patients who are unable to meet nutritionalrequirements. Low adherence is associated with wastage of unfinished ONS, delay in improving patients%u2019nutritional status and increased length of stay. This study aims to improve the adherence level of ONSconsumption.KEY MEASURES FOR IMPROVEMENT:The ONS adherence level is reflected by the amount of ONS being consumed by patients in a day. Thiscan be measured using indicator percentage of calories consumed from ONS in 24 hours over totalcalories requirement. The standard was set at 68% based on the ASPEN Guidelines 2021.PROCESS OF GATHERING INFORMATION:This is a quality improvement study using convenience sampling of geriatric patients receiving ONS inHospital Kuala Lumpur. Data was collected from dietitian notes and medical records. Verification study(n=30) was conducted in 2020, remedial action in November %u2013 December 2022 (n=66) and post-remedialphase in January -December 2023 (n=256). The barriers of factors associated with ONS were alsoidentified.ANALYSIS AND INTERPRETATION:The verification study showed 40% adherence to prescribed calories from ONS. The contributing factorswere dislike taste (10%), ONS not received (10%), loss of appetite (30%), feeding regime not done (30%)and others (20%).STRATEGIES FOR CHANGE:Strategies included compulsory dietitian follow-up within five days of referral, two servings of ONS withhigher calories during breakfast and afternoon replacing the tea and coffee, and flavoured ONS wasintroduced to improve intake. Pantry checking was done regularly to reduce wastage. Continuous NursesEducation was carried out.EFFECT OF CHANGE:Adherence level increased from 40% to 69.5% exceeding the standard set at 68%. Among contributingfactors with improvement were loss of appetite (30.8%) and intolerance (6.6%).THE NEXT STEP:Implementations of remedial actions to all patients consuming ONS at Hospital Kuala Lumpur will becarried out. Clinical audit will be done to improvise adherence levels.64 | Page