Background 
Malnutrition post stroke is associated with increased mortality, reduced functional recovery and increased hospital readmission rates. The prevalence ranges from 6% to 62% in Canada. Dysphagia, fatigue, decreased functional status and cognitive deficits are some factors that increase the risk. The Canadian Stroke Best Practices recommendations include periodic malnutrition risk screening in the community for patients post stroke with a validated tool. Malnutrition is under recognized in this outpatient population. This Quality Improvement Project (QIP) addresses this gap by identifying patients at risk of malnutrition in the Stroke Prevention Clinic using the Malnutrition Screening Tool (MST). The subsequent provision of nutrition intervention optimizes nutritional status and contributes to recovery.

Methodology 
The validated MST consisting of 2 questions regarding appetite and recent unintentional weight loss was selected. It was implemented in the Stroke Prevention Clinic from January 15th to February 26th, 2018. The RD Student or Registered Dietitian performed the screening and provided nutrition intervention as needed. Ethics approval was not required.

Results 
In total, 99 patients were screened and 23 (23.2%) were at risk of malnutrition (50% male, 50% female). Of the 23 at risk, 17 (73.9%) expressed interest in nutrition intervention.

Conclusion
This QIP provides a novel interprofessional collaboration opportunity, identifying patients at risk of malnutrition in the Stroke Prevention Clinic. It is essential that stroke prevention strategies target malnutrition to improve outcomes. The literature and results demonstrate the need and value for routine implementation of the MST and nutrition intervention in the clinic.

IMPLEMENTATION OF A MALNUTRITION SCREENING RISK TOOL IN THE STROKE PREVENTION CLINIC AT TORONTO WESTERN HOSPITAL TO IDENTIFY MALNUTRITION RISK: A QUALITY IMPROVEMENT PROJECT