Nutritional support refers to any method by which we provide nourishment when it is difficult for us to eat normally, such as tube feeding with special liquid formulas inserted directly into your stomach, bowel or bloodstream. This may involve tube feeding (known also as enteral feeding).
Nutrition support professionals include dietitians, nurses, pharmacists, physicians and advanced practice providers who specialize in nutrition care. They undergo on-the-job training before taking an examination to become nutrition support providers.
Enteral Nutrition
Enteral nutrition involves administering formula via a tube into your stomach or intestines to provide optimal nutrition to those who cannot maintain weight and strength through oral consumption alone.
Hospital settings must ensure people receiving nutrition support are closely monitored, including nutritional, anthropometric and clinical assessments. Physicians making decisions regarding this matter should receive advanced training related to this field; staying current on research findings and guidelines would also be wise.
Aspiration pneumonia can occur with nasogastric feeding tubes, so individuals using tube feeding should sit upright when receiving their feeds. Drugs designed to speed up stomach emptying may help lower risk of aspiration as well.
If you require enteral nutrition, Providence Infusion and Pharmacy’s doctors and dietitian can teach you how to use the equipment safely as well as offer advice to avoid complications such as vomiting or constipation.
Oral Nutrition
Oral nutritional supplements (ONS) are liquid or powder dietary aids designed to provide additional calories, proteins, nutrients, minerals and vitamins in order to meet additional calorie and protein requirements, address nutritional deficiencies or support overall wellness. ORNS may be prescribed in order to support pulmonary wellbeing as well as address any nutritional gaps.
People receiving ONS should be monitored closely by healthcare professionals with the necessary skills and training, with particular attention paid to weight loss and disease-related malnutrition. This may involve conducting full clinical and biochemical assessments on each person.
Care homes must ensure all staff are trained to identify signs of malnutrition, such as unintended weight loss, fragile skin, poor wound healing, apathy and wasted muscles. When concerns are identified regarding someone’s nutrition status such as diabetes, renal failure, gastrointestinal symptoms or malabsorption they should refer them for support immediately – in an ideal world all hospital trusts would form multidisciplinary nutrition steering committees composed of gastroenterologists/GI surgeons/nurses/dietitians/pharmacists and laboratory support staff among others.
Artificial Feedings
Rarely, when oral nutrition no longer provides sufficient sustenance, people may require artificial feeding via tubes inserted into their mouth or rectum (nasogastric tube or gastrostomy tube). These feedings consist of specially-formulated mixtures of fats, carbohydrates, proteins, sugars and vitamins which are administered through these tubes directly into their gut or blood stream for delivery directly through these routes, known as Parenteral Nutrition.
Feedings require careful management and can be costly, yet provide quality of life benefits to patients, carers and their families. Malnutrition impedes healing processes while increasing hospitalisation rates as well as care costs related to medicines, care aids, etc.
Provide nutritional support through these methods requires the expertise of a multidisciplinary team, consisting of at least a physician, nurse specialist, dietician and pharmacist who has experience managing PN. This group is commonly known as the Nutrition Support Team or NST.
Fluid Therapy
Nutritional support services provide intravenous fluid therapy and nutritional solutions to those unable to eat or drink on their own. They are overseen by doctors, pharmacists, and dietitians.
Physician Assistants (PAs) are nationally certified, state-licensed medical professionals who work on healthcare teams alongside physicians to prescribe medications across all 50 states and D.C.
Professional nutritionists can assess a person’s dietary requirements and may suggest nutritional support therapies as part of an individualized treatment plan.
Nutritional support strategies tend to increase caloric intake and body weight in critically ill individuals; however, they don’t always improve outcomes among polymorbid general medical inpatients; perhaps due to a lack of high-quality trials on nutritional support for these patients.
