Nutrition in Hospitals Dietetic Dept, GRI

1. Nutrition in HospitalsDietetic Dept, GRI

2. Aim. To understand the importance of nutrition for hospital patients To enable the nursing staff to utilise the Dietetic Dept appropriately

3. Developed by QIS Covers all hospital patients in all hospital settings Standards focus on many aspects of a patients nutritional care Health Boards are audited every 2-3 years to see that they are achieving the standards

4. To improve nutritional care of all patients Screen all patients Formulate care plans to meet their nutritional needs Meet their nutritional needs with choice Improve communication Develop training

5. Research studies have shown that malnourished patients will continue to lose weight if not identified and treated, This can lead to: Weight loss and muscle loss Lack of energy Reduced immunity to infection Poor wound healing Longer hospital stay

6. A person�s health can be affected by their nutritional status, with some being more vulnerable to malnutrition than others Malnutrition is very common in hospitals McWhiter & Pennington (1994) 40% of patients were undernourished on admission to hospital 67% of all patients lost weight while in hospital 43% of the elderly were undernourished

7. Importance of Nutrition The provision of good quality food, fluid & nutritional care is an integral part of the therapeutic care provided in hospital However, the clinical importance of nutritional care is often overlooked Nutritional care requires the effort of many, including Medical staff - Dietitian Nursing staff - Catering Staff Pharmacist - Patient Porter Staff

10. Reasons for Screening To improve the nutritional care of all patients it is essential to identify where problems exist. All patients should be screened as near to admission time as possible, ideally within 24 hours of admission or at the earliest opportunity. Appropriate referrals to the Dietetic Dept

11. Nutritional screening should help identify nutritional problems. Direct to a care plan. Instigate a care plan . Encourage on- going monitoring 

14. Assessment Screening and Care Planning.Screening of all patients at admission to ensure that they can eat and drink. Assessment of nutritional status of patients Height/Weight calculating Body Mass Index Weight change Ability to eat and drink [physical] Skin condition [related to pressure sore prevention] Gut function e.g. malabsorption, nausea, sickness, diarrhoea Stress from disease e.g. surgery, infection, multiple injuries, burns

15. Nutritional Screening Helps dietitian�s prioritise who needs to be seen Weighing patients helps us calculate a patients nutritional requirements Completing food record charts, dietitians can calculate a patients nutritional intake Formulate a nutritional care plan

16. Provision of Nutrition Normal menu Normal menu � high energy, diabetic, soft, Fortify foods , extra snacks Nutritional supplements (prescribe on drug kardex) Fortisip, Fortijuice, Fortifresh Calshakes, Maxijul, Calogen, Procal Enteral Feeding Parenteral Feeding

17. Nutritional Supplements

19. Planning and Delivery of Food and Fluids. Patient menus are nutritionally analysed Normal nutritional needs are met from the hospital menu Patients are given the opportunity to choose meals* Set mealtimes and importance of mealtimes Staff are available to help patients eat Local arrangements in place and everyone is aware of how to access food if a patient misses a meal *Require interpretation at local site, as systems vary

20. Education and Training for Staff. Specific roles e.g Diabetes, renal, Intensive care Screening PACE for Care Assistants � Nutritional care of elderly patients PACE training for trained nurses Nutritional care hospitalised patients see training notice board Food Handling Training Complex nutrition for MDT Nurse, Pharmacist, Dietitian and Medical staff National training programmes are available.

21. Any Questions?