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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

Department of Nutrition and Dietetics

Laura Haigh


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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


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Why might patients become undernourished?

  • Decreased food intake

  • Increased nutritional/energy requirements

  • Decreased nutrient absorption (diseases affecting the gastro-intestinal tract)


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What are the consequences of malnutrition?

→Illness

→ Reduced food intake

→ Reduced muscle strength

→ Decreased mobility

→ Impaired immunity

→ Susceptibility to wound/chest infection

→ Apathy

→ Depression


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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


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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


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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


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Patient Benefits

↓ Length of stay

↓ Rehab time

↓ Mortality

↑ Quality of life

NHS Benefits

Cost savings

Benefits of Nutritional Support


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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


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Why weigh?

  • Weight is an essential component of assessing nutritional status

  • Weight history highlights changes of significance

  • Unexplained weight loss should be investigated


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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


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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


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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


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Appropriate food choices

  • British Nutrition Foundation (2007)


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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

  • 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


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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..

  • 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


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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


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Thank you

Any Questions?

Any Questions?

Any Questions?


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