Nutritional support refers to providing essential nutrition through intravenous or enteral delivery in order to ensure those suffering from nutritional deficits receive sufficient nourishment and fluids.
Nutrition support professionals include dietitians, nurses, pharmacists, physicians and advanced practice providers who specialize in providing nutrition support for their patients and families. These professionals work directly with both parties involved to formulate an individual treatment plan.
Identifying a patient’s nutritional needs
Healthcare professionals should regularly observe inpatients receiving nutrition support. This monitoring should include dietary assessments, as well as anthropometric and clinical observations; depending on a patient’s state of illness or metabolic instability, observations may need to be adjusted in frequency.
Identification of nutritional needs for patients is an intricate task requiring input from multiple disciplines. When conducting assessments on their nutritional status it is vitally important to take into account factors like weight, age and medical conditions as well as unintentional weight loss or decreased appetite.
Nutrition support providers include dietitians, nurses, pharmacists, physicians or advanced practice providers who specialize in administering enteral and parenteral nutrition to patients in hospitals and home settings. Utilizing standard methods, equipment and formulations they administer enteral and parenteral nutrition to patients in these settings. They may also teach families and caregivers how to best feed their loved ones. Nutrition support should be sought when food intake or nutrient absorption will be compromised for an extended period; such interventions can prevent starvation as well as improve patient outcome.
Developing a treatment plan
Artificial feeding offers vital additional nutrition (nutritional support). Tube-fed formulas that include carbohydrates, proteins, fats, vitamins and minerals provide these vital components of human nutrition through tube delivery systems. Artificial feeding may be useful in patients who cannot eat due to illness, disability, surgery or injury as well as dying or severely demented individuals.
Doctors use equations to select an appropriate nutrition formula based on weight, height and age of their patients. When consulting dietitians regarding nutrition plans they ensure their patients’ conditions and goals are appropriately addressed by this combination of nutrients.
A nutritional care team includes nurses, dietitians, pharmacists and physicians certified in nutrition support. It’s crucial that these healthcare professionals remain up-to-date with current research and best practices; one way they can do this is through joining ASPEN which offers conferences, peer-reviewed journals and other resources for professional nutrition support professionals.
Monitoring a patient’s progress
Monitoring patient care to make sure nutrition support therapy is working effectively requires measuring certain parameters at regular intervals and recording them on a chart. The monitoring process typically begins at the start of their care episode and should continue until their discharge from care.
Monitoring patient conditions allows nurses to quickly detect changes that require intervention, such as sudden increases in temperature or low oxygen levels that could indicate sepsis complication – an outcome which could prove fatal if left unchecked. It’s therefore crucial that nurses keep tabs on patients in real time for any changes that warrant immediate action from nurse caregivers.
Family physicians should closely oversee patients receiving EN or PN to evaluate dietary tolerance, signs of dehydration or volume overload, complications from their feeding tube (e.g. nasal erosion, migration or leakage) as well as possible issues surrounding it (such as nasal erosion). Furthermore, patients should also regularly be evaluated for glycemic control along with lab values including complete metabolic panel, blood count, triglycerides magnesium and phosphorus values to measure ongoing progress and assess future needs.
Developing a discharge plan
An effective discharge plan is key to helping patients and their families make a seamless transition from hospital care into other forms of support, particularly among older people who may experience memory problems. A well-developed discharge plan should include lists of home health agencies, community services, available resources, patient education as well as patient and family education – especially crucial when transitioning from memory issues.
Malnutrition is an ongoing challenge among hospitalised older patients, and can have severe repercussions for quality of life, carer satisfaction and outcomes. Unfortunately, it is impractical for hospitals or clinics to screen all inpatients immediately upon admission or at their initial clinic appointment for malnutrition screening.
Discharge planning includes an intensive review of a patient’s medical history and current medications, equipment/supplies needed upon discharge, social support systems available and transportation needs. Hospitals should provide lists of HHAs, SNFs, IRFs and LTCHs in their area that can assist patients in transition.
