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Food, Fluid and Nutrition

Food, Fluid and Nutrition. Q.I.S. Embraces several quality and patient focussed organisations in to one National standards of care are set for various groups e.g. Elderly in acute care, various cancer sites, Chronic conditions e.g. Diabetes, renal. O I S. Q I S. NMPDU. CSBS.

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Food, Fluid and Nutrition

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  1. Food, Fluid and Nutrition

  2. Q.I.S. • Embraces several quality and patient focussed organisations in to one • National standards of care are set for various groups e.g. Elderly in acute care, various cancer sites, Chronic conditions e.g. Diabetes, renal.

  3. O I S Q I S NMPDU CSBS SHAS HTBS CRAG

  4. A report is produced • Commending good practice • Making recommendations for improvement- challenges • Standards are re -audited 2 – 3 years later to monitor compliance and improvements Boards are audited

  5. Food, Fluid and Nutrition Standard Scope of standard, embraces many aspects of patient carePatients who can eat and drink normally meeting their needsPatients who can eat and drink but don’t meet their needs

  6. Patients who need supplementary drinks to meet their nutritional requirements.Patients who need enteral tube feeding to meet their needs.Patients who require Total Parenteral feeding as the gut is unavailable.

  7. Whose business is it? • Caterer • Doctor • Dietitian • Nurse • Patient • Pharmacist • Porter

  8. Research studies have shown that malnourished patients continue to lose weight if not identified and treated, the consequences are as follows:- Weight loss and muscle loss Lack of energy Reduced immunity to infection Poor wound healing Longer hospital stay

  9. 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.

  10. LOW RISK 0 - 5 • Encourage normal diet • Check weight and re-screen weekly. • Re-assess if condition changes MEDIUM RISK 6 - 9 Commence 3 Day Food Record Chart. Check weight twice weekly. Re-assess after 3 Days. Beatson Oncology Centre: Refer to Medium Risk Flow Chart Intake / weight increasing Intake / weight not increasing Continue to encourage oral diet Refer to dietitian HIGH RISK 10+ Beatson Oncology Centre: Refer to High Risk Flow Chart Refer to Dietitian and Medical Staff *during latter stages of palliative treatment weighing of patients to assess nutritional status may not be appropriate as weight loss may be as a result of the under lying disease

  11. 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, multipleinjuries, burns 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 Development of action plan and multi-disciplinary care plans involving referral to specialist services e.g. Dietetics, OT, SALT, Dentist

  12. Screening This should identify problems. Direct to a care plan. Instigate a care plan . Encourage on- going monitoring (regular weighing)

  13. 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 Planning and Delivery of Food and Fluids.

  14. Meal choice is available and patients given help to choose Portion size Temperature Patient satisfaction Provision of Food and fluid to patients. • Require interpretation at local site, as systems vary

  15. Communication between wards, patient and staff is essential for success.This should be ideally available before admission or in a pack available in the ward

  16. How to order meals Meal and snack times choices available Out of hours meals Food brought in Food storage and labels Special equipment How to comment

  17. 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. Education and Training for Staff.

  18. 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 Aims of Standard

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