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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

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The Importance of Nutrition

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  1. The Importance of Nutrition Department of Nutrition and Dietetics Laura Haigh

  2. 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

  3. 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

  4. Why might patients become undernourished? • Decreased food intake • Increased nutritional/energy requirements • Decreased nutrient absorption (diseases affecting the gastro-intestinal tract)

  5. What are the consequences of malnutrition? →Illness → Reduced food intake → Reduced muscle strength → Decreased mobility → Impaired immunity → Susceptibility to wound/chest infection → Apathy → Depression

  6. 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

  7. Role of the dietitian • 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

  8. Catering system • 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

  9. Patient Benefits ↓ Length of stay ↓ Rehab time ↓ Mortality ↑ Quality of life NHS Benefits Cost savings Benefits of Nutritional Support

  10. 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

  11. Why weigh? • Weight is an essential component of assessing nutritional status • Weight history highlights changes of significance • Unexplained weight loss should be investigated

  12. How should weights should be obtained? • 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 • Re-check the weight • Inform the named nurse if concerned

  13. Completing menu cards • Are menu choices appropriate? • Clarify likes/dislikes • Observe physical limitations which may impact intake • Offer assistance if required • Offer encouragement

  14. How to Complete Food Record Charts

  15. Methods of providing Nutritional Support • Appropriate food choices/↑ no. of meals/snacks • Fortify foods to ↑ their nutritional value • Provide supplement drinks • Enteral nutrition • Parenteral nutrition

  16. Appropriate food choices • British Nutrition Foundation (2007)

  17. 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

  18. Nutritional Supplements • Some can not meet their nutritional needs through oral diet alone • Supplement drinks may be indicated • Prescription products should only be given to patients as directed by medical or dietetic staff

  19. 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

  20. Nutrition Support cont.. • 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

  21. Check List • Request Nursing Staff complete Nutritional Screening Tool • Weighing patients • Appropriate meal provision 1. Completing menu cards 2. Supervising on appropriate food choices 3. Food fortifying 4. Assistance offered if required 5. Suitable position for food consumption 6. Appropriate cutlery • Food record charts

  22. Thank you Any Questions? Any Questions? Any Questions?

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