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

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

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.

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

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

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.

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

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.

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

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

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.

Main food Groups

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

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

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

Thank you for your time Please complete question sheet and feedback sheet