At what rate are oral nutritional supplements delivered and what factors may explain non-delivery?

Karen Lee1
Bairnsdale Regional Health Service1


Background: Malnutrition amongst hospital patients continues to be a problem with up to 40% of patients presenting as malnourished on admission or are at-risk of developing hospital-acquired malnutrition. An important strategy in treating and reducing the prevalence of malnutrition is through interventions such as dietitian-prescribed oral nutritional supplements (ONS). ONS can improve patient outcomes by preventing further loss of weight, reducing risk of complications, and reducing length of stay. Despite the well-recognised benefits of ONS, their effectiveness can be limited by the success of ONS delivery.

Aim: To investigate the delivery rate of ONS and identify potential barriers to successful delivery.

Method: This observational study was conducted across three wards at Bairnsdale Regional Health Service on randomised days across a six month period. The study consisted of two components. The first component involved the researcher and/or Dietetics Allied Health Assistant physically tracking and auditing the delivery of ONS across all six meal periods, and recording whether or not ONS was delivered. The second component involved Food Service Assistants (FSA) completing a survey which assessed perceptions of ONS and perceived barriers to successful delivery.

Results: Preliminary results based on 444 data points (n = 90) show that overall 17.8% of ONS were not delivered. While there were some differences in non-delivery rates of ONS between morning tea and afternoon tea (11.8% and 23.6%, respectively), there were no other significant associations between ONS delivery and meal periods. The analysis of the type of supplements delivered showed that nutritionally complete supplements are 12.9% more likely to be delivered than non-nutritionally complete supplements which had a non-delivery rate of 25.4%. The FSA survey (currently in progress) may help to explain these findings.

Conclusion: Preliminary data suggest that there is no causative relationship between ONS delivery and meal periods. However, other factors such as Food Service Systems, and FSA perceptions and understanding of dietitian-prescribed ONS, whether nutritionally complete or non-nutritionally complete, may influence ONS delivery rate.


Karen graduated in 2019 with a Master of Dietetic Practice from La Trobe University and is employed at Bairnsdale Regional Health Service as a Grade 1 dietitian. She is passionate about promoting nutritional therapy and providing positive clinical outcomes to patient; optimising long-term health and wellbeing beyond their hospital admission.

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