1097 / The nutrition care plan for hospital patients

CROATIA
Classification of the PSP
Type of Patient Safety Practice Not Proven Effective
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Malnutrition
Patient education There is no specified text here
Topic of the reported practice
Patient safety system
Aim and the benefit of the Patient Safety Practice
 
Among patients admitted to hospital there is a group who can be classified as being at nutritional risk. This means that the patients nutritional status and/or their spontaneous energy intake, combined with the severity of the disease with which they are admitted, may increase the morbidity and the length of stay. Patients often have reduced appetite, nausea or aversion towards certain types of food, which may partly explain the inadequacy of their food and liquid intake. Intervention studies have shown that outcomes improve when patients are screened for the risk or presence of malnutrition and receive an early nutritional care program. Offering food or in-between meals rich in energy and protein, it is possible to increase the patients protein and energy intake.
Description of the Patient Safety Practice
 
This protocol is planned for the patients at high nutritional risk. Identifying nutritional problems leads to formulation of a nutrition care plan.
Dietitians conducted a full nutritional assessment and implemented a nutritional care plan. The nutritional care plan consist of: assessing nutritional status, identify nutrition-related problems, planning and prioritizing nutrition intervention to meet these needs and evaluating the nutritional care outcomes. Meals are recorded and energy value is calculated. Measures of plate waste (percentage of the served food that is discarded) have been used to provide feedback on food acceptability to help plan menu changes and to monitor the adequacy of food intakes. Enabling the patients to some extent to choose their meals individually, in combination with a change in the meal towards higher energy density, could increase the energy and protein in patients with low intake.
These data can contribute to raise our knowledge of nutritional care in general and to identify issues crucial to an improvement of hospitalized patients food intake in particular.



Identification of a patient at nutritional risk

For the patient at 'high risk' the action was to focus on encouraging with eating and drinking, replace missed meals with supplements or other meals and repeat score after three to four days and ask medical staff to refer patient to clinical dietician.



Description the nutrition care plan

In Form patient data related to the nutritional care were collected upon admission: height, body weight, BMI, usual body weight and changes in body weight for a defined period (if possible), malnutrition risk factors (MNA, SGA), oedema or dehydration, the date and by whom the patient had been informed about the food service, the result of the first assessment of the nutritional status, a short description the patients ability to eat and drink, and of the action taken by dietitian, the date of the next assessment of the nutritional status.

References:
Mahan L. K, Escott-Stump S. Krause¨s Food, Nutrition, & Diet Therapy, 11izd. 412-413. 2000.

Description Plate waste

Plate waste refers to percentage of the served food that is discarded. Visual estimation uses a scale to measure approximately what proportion of food is left. The scales that have been used is the 4-point scale (all, 1, 1, none). Results of plate waste estimates are most commonly presented as the percentage by weight of the served food remaining uneaten.

http://www.nutritionday.org

Malnutrition risk faktors:

MNA (Mini Nutritional Assessment)
The full MNA® is a validated screening tool that identifies elderly persons who are malnourished or at risk for malnutrition. The full MNA® is the original version of the MNA® and takes 10-15 minutes to complete. The full MNA® is an excellent tool for the research setting. It may provide additional information about the causes of malnutrition in persons identified as malnourished or at risk for malnutrition.
Recommended intervals for screening with the MNA® are annually in the community, every three months in institutional settings or in persons who have been identified as malnourished or at risk for malnutrition, and whenever a change in clinical condition occurs.
The MNA® was developed by Nestlé and leading international geriatricians. Well validated in international studies in a variety of settings6-8, the MNA® correlates with morbidity and mortality.

References:

http://www.mna-elderly.com/default.html


SGA (Subjective Global Assessment)
SGA is a simple, routinely used and proven method for gaining a subjective judgment of nutritional status. It uses a questionnaire which records the patient's medical history and the findings of a physical examination. Factors assessed include weight change, appetite or anorexia, subcutaneous tissue and muscle, and GI symptoms.

References:

http://www.hospitalmedicine.org/AM/Template.cfm?Section=Home&TEMPLATE=/CM/HTMLDisplay.cfm&CONTENTID=7233

Attachment of relevant written information and/or photos, as appropriate
2014052610162322524_WP4_Nutrition Care Plan_english.doc
There is no specified text here
There is no specified text here
There is no specified text here
Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, partly
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
Effect not known or the intervention has not yet been evaluated
Type of before-and after evaluation
Qualitative
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
There is no specified text here
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Dieticians/ Nutritionists
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Yes
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
Patient(s)
Relative(s)
Patient representative(s)
Point of time in which service user or their reprasentatives' involvement takes place
During the application of the Patient Safety Practice
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
Yes
Short description of the service users' level of involvement
Not known
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Sharing of progress information among involved staff
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Irena Martinis
Country: CROATIA
Organisation: University hospital Dubrava
E-mail: mirena@kbd.hr
Phone: +38512903325
Print
Top
At la sikisen cesaretli kadina 50 cm at yarragi giriyor hayvanli porno izle
sirinevler escort sirinevler escort atakoy escort mecidiyekoy escort etiler escort atasehir escort capa escort
usak escort elazig escort
sex filme
porno
sirinevler escort beylikduzu escort atakoy escort sisli escort atakoy escort sisli escort sirinevler escort beylikduzu escort halkali escort halkali escort istanbul escort beylikduzu escort beylikduzu escort sirinevler escort sirinevler escort beylikd�z� escort �i�li escort �irinevler escort avrupa yakasi escort �apa escort beylikd�z� escort