Nutritional Support Study Session for HCSW in practice

1. Nutritional Support Study Session for HCSW in practice Staff Nurse Tracy Culkin

2. Aims of this discussion To discuss the rational behind: • Hospital Regulations on nutrition • Nutritional Support & Services • Main food Groups • Factors that effect patients eating habits and appetite • Factors that effect daily food intake • Maintaining patents dignity when feeding

3. Hospital Regulations on Nutrition • To ensure that all patients have their nutritional needs assessed and a plan of care/support is initiated to meet those needs • That any special dietary requirements are recorded and met, for example gluten free, vegetarian & texture modification • That all patients who are unable to consume food orally have alternative provisions made using artificial nutritional methods. This may include a combination of oral and non-oral feeding routes.

4. Roles and Responsibilities Roles and responsibilities are embraced by a wide range of people listed below: • Nutritional steering groups • Nutritional support groups • Patient environment action teams • Essence of care groups • Matrons • Enteral feeding teams • Social work staff • Medical staff • Nursing staff • Healthcare support workers • Dieticians • Speech and language therapist • Catering team

5. The Framework Key aspects of the nutritional framework are: • Safety • Providing assistance • Nutritional screening • Food provision • Care/support plan • Education and training • Artificial nutrition • Public health • Audit

6. Audit, Planning and Monitoring • Over the past few years, there have been many changes in health and social care which have increased the need to work more closely with service uses and their families. • The main reasons are not just related to food but are across all the services we provide as a trust.

7. The main reasons are due to • People who use are services are more informed which have increased the need to work more closely with them and thier families • Feedback on our performance • Staff changes due professional workload across the board • Engagement with service users and carers to promote equality, partnership and dignity

8. The need for staff Training • Guidelines from the National Patient Safety Agency states all people providing nutritional care should have the appropriate skills and competencies to ensure that people in receipt of support services receive good nutritional care.

9. NPSA States we need to target • Staff or volunteers who assess and provide for peoples’ care and nutritional needs/or undertake nutritional screening • Those who prepare or deliver food to service uses (catering staff) • Those who assist people with thier own preparation or consumption of food (day care) • Those who are involved in contracting service inspection and regulation

10. What should be included in staff training • Basics of nutrition and hydration • 10 key characteristics of good nutritional care in hospitals • Meal preparation • Cultural and religious diets • Why people become malnourished/dehydration • Consequences of malnutrition • Identification, treatment and monitoring of nutritional needs • MDT expertise dieticians, occupational therapists, and speech and language therapists

11. Main Food Groups • No single food contains all the nutrients needed for health so we should try to eat a balanced diet. By choosing a variety of foods from the five food groups, most people will get all the nutrients they need to stay healthy and active.

12. Main food Groups

13. Factors that effect patients eating habits and appetite • Special diets and menu planning • Stimulating food and drinks • Dementia • Diabetes • Altered consistency and swallowing difficulties, dysphasia management • Signage • Artificial nutritional support • Oral nutritional support • Obesity • Food allergies • Health eating

14. Factors that effect daily food intake • Crockery, cutlery • Kitchen equipment • Presentation • The eat environment • Physical position • Protected mealtimes • Availability of snacks • Company • Choice • Dignity and respect • Support and encouragement • Oral health • Ability

15. Patients dignity when feeding • Ensure that the patient is in a safe comfortable eating position • Provide appropriate equipment preferably wash hands, provide wipes • Encourage involvement prior to meal arriving • Clear table tops from clutter • Environment, reduce noise, distraction • Provide assistance –feeding/opening packages ect • Observation- making sure they can eat • Monitoring/assessment –record food and fluid intake

16. Thank you for your time • Please complete question sheet and feedback sheet