Name of Measure: Food Fluid and Nutrition Care Plan 
                 (Shown on CAIR as: FFN Care Plan) 
     
    Date of Completion: May 2020 
     
    Working group:                Measure ID:  
                                   
    Nutrition                     FFN3 
                                   
    Rationale: 
     
    Appropriate food and fluid provision needs to be recognised as a fundamental part of every 
    patient’s clinical care.  
     
    Malnutrition affects every system in the body and always results in increased vulnerability to 
    illness, increased complications and in very extreme cases even death. The majority of people 
    who are malnourished or at risk of malnutrition are living in the community. Hospital admission 
    presents an opportunity to identify malnutrition and initiate treatment, 25-34% of patients admitted 
    to hospital are at risk of malnutrition (British Association for Parenteral and Enteral Nutrition 
    (BAPEN), 2018). 
     
    Malnutrition can happen very gradually, which can make it very difficult to spot in the early stages. 
    Screening and assessment processes help identify malnutrition and factors that may prevent 
    patients from eating and drinking appropriately to meet their nutritional requirements.  
     
    Once an individual has been assessed as being at risk of malnutrition a person centered 
    nutritional care plan needs to be developed, followed and reviewed. 
     
    The aim is that, if required, a person-centred nutritional care plan is documented which reflects 
    the outcome of malnutrition screening and assessment. 
     
    References: 
     
    Website: https://www.bapen.org.uk/malnutrition-undernutrition/introduction-to-malnutrition 
    (BAPEN, last updated 2018) 
     
    Todorovic V, Russell C, Elia M (Eds) (2011) The ‘MUST’ Explanatory Booklet: A Guide to the 
    ‘Malnutrition Universal Screening Tool’ (‘MUST’) for Adults. Malnutrition Action Group (MAG), a 
    Standing Committee of BAPEN  
     
    Definition: 
     
    Of the total number of patients identified as having a medium or high risk MUST Score (≥1) in 
    FFN1 (MUST Score), the percentage where a nutritional care plan was documented in their case 
    notes. 
     
    Reference Point:  95%  
                                
                           
                                                                                       
         Based on testing. 
          
         Nursing/Midwifery Family: 
          
         Adult inpatient 
                  
         Inclusion Criteria:                                      Exclusion Criteria: 
                                                                   
            Adult inpatient wards                                   Paediatric patients 
            Patients with a Medium or High Risk                     Adult patients in community settings active on 
             MUST Score (≥1)                                          nurse caseload 
                                                                     Maternity patients 
                                                                     Patients with a Low MUST Score 
                                                                           
         Calculation: 
          
         Numerator: Number of documented nutritional care plans in case notes 
          
         Denominator: Number of patients identified as having a medium or high risk MUST Score (≥1) in 
         FFN1 (MUST Score). 
          
         Will be presented as a percentage compliance and will be calculated as: numerator/denominator 
         x100 
          
         Submission: Monthly submissions, based on assessments completed in the previous calendar 
         month 
          
         Data Items required for the measure: 
          
             1.  Location Code: To be included in Submission Template (based on National Reference file 
                 maintained by ISD) 
             2.  Sub-location Code: To be included in Submission Template (based on ward/team 
                 reference file maintained by each Board) 
             3.  Measure ID: FFN3 
             4.  Date 
                     a.  Definition: 1st of the previous calendar month (e.g. Data submitted in March 2020 
                         will be from assessments completed during February, therefore, this data item 
                         should be recorded as 1st February 2020) 
                     b.  Format: Date YYYYMMDD 
             5.  Numerator  
                     a.  Definition: Number of documented nutritional care plans in case notes  
                     b.  Format: Whole number 
                     c.  Additional Information: 
             6.  Denominator  
                     a.  Definition: Number of patients identified as having a medium or high risk MUST 
                         Score (≥1) in FFN1 (MUST Score). 
                     b.  Format: whole number 
                     c.  Additional Information:  
                                                                    
                                                                                        
                          
         Further Information: 
          
         Available at Ward/Team level. 
          
         Any further notes here: 
          
         Supporting guidance for what should be included in person-centred nutritional care plan is 
         detailed below.  
          
         Person-Centred Nutritional Care Plan Guidance: 
          
         Where assessed as being required, a person-centred nutritional care plan is developed, followed 
         and reviewed with the patient and includes: 
          
                Outcomes of screening for the risk of malnutrition and dietary advice to be followed, any 
                 dietary recording records to be used  
                Outcomes of the initial nutritional care assessment and care to be delivered as result of 
                 assessment 
                A clearly defined goal or desired outcome e.g. prevent further weight loss, maintain current 
                 weight or improve nutritional status. This should reflect underlying cause and symptoms of 
                 malnutrition  
                Any assistance required at mealtimes 
                Frequency and dates for repeat screenings and care plan review 
                Evidence that this has been discussed and agreed with the person 
         For further information email us or refer to the CAIR website 
          
          
         Document History 
         Version       Date            Comment                                                     Author(s) 
         1.0           24/04/2020  Final Version for Publication                                   Laura Cameron 
                                                                                                    
          
         Update from Previous Version 
                           
                           
         .