1. ‘Innovative Nutrition & Swallowing Training’ Leah Platt Community Dietitian September 2011

2. Portsmouth Hospitals NHS Trust Background to Project  Funded by NESC.  7 Month project to deliver bespoke training programmes to Nursing Homes in Portsmouth City.  Joint Project between SALT (Solent Healthcare) and Dietitian (Portsmouth Hospitals NHS Trust).

3. Portsmouth Hospitals NHS Trust Project Aim Reduce hospital admissions from nursing homes by enhancing local skills in identifying and managing risks of malnutrition and dysphagia. Objectives  Implement accurate ‘MUST’ screening and appropriate use of care plans  Improve the identification of dysphagia and use of safer swallowing strategies  Improve mealtime experiences

4. Portsmouth Hospitals NHS Trust Project Overview Identified / invited homes Engaged stakeholders Visited homes Piloted Training Reflected & revised Assessed training needs Pre-training data Delivered training Developed tailored training

5. Portsmouth Hospitals NHS Trust Delivered follow-up training Collected post-training data (4-6 weeks post training) Analysed and evaluated training Practical recommendations discussed Produce Recommendations and Publicise Findings

6. Portsmouth Hospitals NHS Trust Why was this training different? Evaluated Effectiveness Dual Professional Provided tailored programmes Engaged NH In assessment of training needs Group and Individual Training Used variety of teaching methods

7. Portsmouth Hospitals NHS Trust Reaction of Students Learning Behaviour Results Did targeted outcomes improve? Did the training increase knowledge? How did participants react to training? Did behaviour change? Outcome Measurement: Kirkpatrick’s Training Model

8. Portsmouth Hospitals NHS Trust Outcome: Reaction of Students Reaction of Students Learning Behaviour Results How did participants react to training?

9. Portsmouth Hospitals NHS Trust Reaction from Participants  Good reaction from participants 1 2 3 4 5 4.8 - Clarity, Interest, Relevance

10. Portsmouth Hospitals NHS Trust  Increased Confidence - High confidence ratings for supporting residents at mealtimes both pre & post training

11. Portsmouth Hospitals NHS Trust Outcome: Learning Reaction of Students Learning Behaviour Results Did the training increase knowledge, skills, attitudes, confidence, commitment?

12. Portsmouth Hospitals NHS Trust  Improved Knowledge

13. Portsmouth Hospitals NHS Trust Outcome: Behaviour Reaction of Students Learning Behaviour Results Did behaviour change? Did people apply knowledge on the job?

14. Portsmouth Hospitals NHS Trust  Continued Completion of ‘MUST’ -Improved frequency of ‘MUST’completition post training -More staff involved with ‘MUST’ and care planning

15. Portsmouth Hospitals NHS Trust  Increased Provision of Snacks  Increased Provision of Homemade Fortified Milkshakes

16. Portsmouth Hospitals NHS Trust  Increased Use of Food Fortification Ingredients - Dried milk powder, condensed milk, evaporated milk, cream, cheese, butter/margarine

17. Portsmouth Hospitals NHS Trust  Increased Use of Fortification Ingredients

18. Portsmouth Hospitals NHS Trust  Improved Mealtime Practices

19. Portsmouth Hospitals NHS Trust Outcome: Results Reaction of Students Learning Behaviour Results Did targeted outcomes improve?

20. Portsmouth Hospitals NHS Trust In year prior to training:  924 GP Contacts  383 admissions to Hospital Plan to Re-Assess Next Year

21. Portsmouth Hospitals NHS Trust Future Actions…  Collect GP Contacts & Hospitals Admissions Data 1Year Post Training  Nutrition & Dysphagia Link Training  1 Day Diet Chef Course

22. Portsmouth Hospitals NHS Trust Learning Points Recognition that changes in practice requires intensive input. ? Impact on Resources Importance of regular training Importance of Evaluation Methods

23. Portsmouth Hospitals NHS Trust Thank you for Listening