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