Transcript The Importance of Nutrition

The Importance of Nutrition
Department of Nutrition and Dietetics
Laura Haigh
Aims of the presentation
Help your understanding of:
Malnutrition and its consequences
 Factors that influence nutritional needs
 The role of the dietitian
 Ward level activities to improve
nutritional intake
 Importance of monitoring nutritional
parameters e.g. weight
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Malnutrition?
What is malnutrition?
 Malnutrition = imbalance between nutritional intake
and nutritional requirements.
 Malnutrition in the UK costs in excess of 7.3 billion
Who is at risk of malnutrition?
 A malnourished patient can  their length of stay in
hospital by 50%
 75% of patients may  weight during admission
 A large proportion of patients are at risk
Auxiliary nurses play a very important role in the
provision of nutritional care
Why might patients become
undernourished?
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Decreased food intake
Increased nutritional/energy
requirements
Decreased nutrient absorption (diseases
affecting the gastro-intestinal tract)
What are the consequences of
malnutrition?
→ Illness
→ Reduced food intake
→ Reduced muscle strength
→ Decreased mobility
→ Impaired immunity
→ Susceptibility to wound/chest infection
→ Apathy
→ Depression
Identifying patients at
nutritional risk
Nutritional screening
 Identifies patients who are or at risk of
becoming undernourished
 Action plan
1. identifies appropriate strategies of care
2. identifies responsibilities for care
 Not all patients identified as being at
risk require being seen by a dietitian
Role of the dietitian
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The dietitian is an expert in nutrition
Assess more high risk patients
Assess nutritional status (ABCD)
Estimate nutritional requirements
Give appropriate nutritional advice
Request prescription products if appropriate
Discuss care plans with multi disciplinary teams
to ensure implementation
Catering system
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Dietitians will inform nursing staff of
specific dietary requirements
Speech and Language Therapist will
inform nursing staff on appropriate
texture modified diet
All meals are ordered by nursing staff
Fortified foods and additional snacks can
be arranged via the dietitian
Benefits of Nutritional Support
Patient Benefits
 ↓ Length of stay
 ↓ Rehab time
 ↓ Mortality
 ↑ Quality of life
NHS Benefits
 Cost savings
Your role in preventing
undernutrition
Think about your job – how much time do you
spend doing food related activities?
 Request Nursing Staff complete Nutritional
Screening Tool
 Weighing patients
 Completing menu cards
 Food record charts
 Advising on appropriate food choices
 Food fortifying
 Meal Provision
Why weigh?
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Weight is an essential component of
assessing nutritional status
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Weight history highlights changes of
significance
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Unexplained weight loss should be
investigated
How should weights
should be obtained?
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Weekly weights (unless otherwise instructed)
Obtain using the same scales preferably
Ensure patient wearing similar clothing
Weights should be recorded in the nursing or
medical notes
If weight has significantly changed
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Re-check the weight
Inform the named nurse if concerned
Completing menu cards
Are menu choices appropriate?
 Clarify likes/dislikes
 Observe physical limitations which
may impact intake
 Offer assistance if required
 Offer encouragement
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How to Complete Food
Record Charts
Ideal
way
Breakfast
Midmorning
Lunch
Midafternoon
Evening
meal
Supper
½ bowl
porridge
Full cup
of orange
juice
All
Fortisip
All tea
biscuit
All soup
½ portion
of mince
&
potatoes
Glass of
milk
¼ Fortisip
Refused
tea biscuit
Refused
main meal
Ate full
high
protein
custard
¾ glass of
milk
Cup of
tea
1 slice
of toast
Biscuit
Soup
Main meal
Enlive
Custard
Tea
Toast
Wrong Some
porridge
way
Methods of providing
Nutritional Support
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Appropriate food choices/↑ no. of
meals/snacks
Fortify foods to ↑ their nutritional value
Provide supplement drinks
Enteral nutrition
Parenteral nutrition
Appropriate food choices
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British Nutrition Foundation (2007)
Food Fortification
Full fat or sugar products
 Add extra butter, cheese, full cream
milk, cream
 Add sugar or preserves
 Food fortification with Procal, Build
Up, Calogen, Fortisip or Fortijuice
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Nutritional Supplements
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Some can not meet their nutritional
needs through oral diet alone
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Supplement drinks may be indicated
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Prescription products
should only be given to patients as
directed by medical or dietetic staff
Nutritional Supplements
Always check the best before
date
 Offer between or after meals
 Offer chilled or at room
temperature
 Ask about flavour preference
 Offer encouragement
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Nutrition Support cont..
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Some can not meet nutritional
requirements
 enteral or parenteral feeding may be
initiated
Provision of these forms of nutrition are
carried out by trained nursing staff
Check List
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Request Nursing Staff complete Nutritional
Screening Tool
Weighing patients
Appropriate meal provision
Completing menu cards
Supervising on appropriate food choices
Food fortifying
Assistance offered if required
Suitable position for food consumption
Appropriate cutlery
Food record charts
Thank you
Any Questions?
Any Questions?
Any Questions?