Standardised Recipes and Diet Specific Menu Cards Presentation by: Barbara Gillman Clinical...

Standardised Recipes and Diet

Specific Menu CardsPresentation by:Barbara Gillman

Clinical Specialist Renal DietitianMater Misericordiae University Hospital

June 2011

Background

• 570 inpatient beds • Average of 255 patients under care of Department of Clinical Nutrition and Dietetics• Range of diets• Cooking method

Mater Misericordiae University Hospital Mater Misericordiae University Hospital

BackgroundWhere were we?

• 3 week menu cycle• No standardised portion control• Limited insight into recipes• No nutritional analysis• Limited choices for therapeutic diets• No specific menu cards• Limited ability to use food provided as education tool for patients• Difficult to manipulate the ‘diet’ to meet nutritional requirements


So what did we do?

• Team • Objective – To Produce and Pilot a Renal Menu Card for inpatients requiring a renal

diet by the end of December 2007


Action Points

• What does current menu cycle provide?• What do we want it to provide?• How can we expand on choice?• How will we use menu card as education tool?• How are diets ordered?How are diets ordered?• Education required?Education required?


What did we do?

• Nutritional Analysis for all food items and recipes • Set standard portion control measures for each food group • Composite recipe analysis - Ingredients - Taste - Texture - Yield


Menu Card

• Colour Coded• Diet Explained Section • Dietitian Requests Section


Phase 2 of ProjectMarch 2008-March 2009

• Develop menu cards for other therapeutic diets - Yellow - Diabetic - Cardio protective - No Added salt - Altered Consistency including Smooth Pureed, Minced and Moist and Soft


So what do we have now?

• For the patient : A 3 week menu cycle with improved palatability, variety in rotation, and better food choice for most patient groups• For the catering department – Standardised recipes and methods as well as agreed portion control measures• For the dietitians – Full nutritional analysis of all food provided as well as teaching tool for therapeutic diets• For the pantry staff – A guide to each diet as well as improved requisition system


RENAL / RENAL DIABETIC DIET RENAL / RENAL DIABETIC DIET RENAL / RENAL DIABETIC DIETMONDAY WEEK 1 MONDAY WEEK 1 MONDAY WEEK 1

□ Small □ Small □ Small□ Grapefruit Segments □ Chicken Pancakes □Chopped

OR □ Beef & Vegetable Casserole □ Fish Fingers & Pasta Salad

□ Orange Juice (100ml) □ Roast Breast of Chicken □ Cold Meat Renal Salad

Cereal □ Baked Fillet of Fish □ Chopped Sandwich

□ Porridge □ 2 Weetabix □ Savoury Minced Beef □ Tuna □ Egg □ Chicken

□ Cornflakes □ Rice Krispies Bread (Sliced Pan) □ No Bread

Bread (Sliced Pan) All Meals are served with Vegetables & □ White □ Brown

□ White □ Brown Potatoes unless otherwise requested □ Flora □ Jam

□ Toast □ Jam □ Marmalade □ Tea □ Hot Water

□ Flora

□ Tea □ Hot Water

□ Blackcurrant Cheese Cake □ Philadelphia Cheese & Crackers

OR□ Fruit Yoghurt (suitable for Renal Diabetic)

OR

RENAL DIET:

For patients with kidney disease □ Flora

Diet must be low in salt and potassium □ Tea

*No salt sachets on tray (pepper only)

*No Cuppa-Soups allowed

*Milk with Cereal and Tea Only

DIET EXPLAINED

Bed No:

□ Puree Fruit & Cream

(suitable for Renal Diabetic)

MATER MISERICORDIAE HOSPITAL

BREAKFAST

DESSERTS

Portion SizePortion Size

Ward:


Bed No:Bed No:


TEA

Portion Size

Ward:

EXTRA SNACKS ALLOWED

SPECIAL REQUESTS

(PLEASE REFER TO DIETITIANS LIST ONLY)

(PLEASE REFER TO DIETITIANS LIST ONLY)

SPECIAL REQUESTS

LUNCH

Ward:

Beef & Vegetable Pie (No Pastry Lid) (No Pastry Lid) (No Pastry Lid) (No Pastry Lid) X X (No Pastry Lid)

Baked Ham X X X X X X

Roast Beef X X

Lamb Ragout X X X

Turkey a La King X X X

Chicken Casserole X X X

Roast Stuffed Pork (No Stuffing) (No Stuffing) (No Stuffing) (No Stuffing) X X (No Stuffing) (No Stuffing)

Bacon & Parsley Sauce X X X X X X

Roast Lamb X X

Steak & Mushroom Pie (No Pastry Lid) (No Pastry Lid) X (No Pastry Lid) X X X (No Pastry Lid)

Baked Trout & Dill Sauce X

Shepherds Pie X

Roast Turkey & Ham (No Ham) (No Ham) (No Ham) (No Ham) X X

Irish Stew (Renal Stew) X X X

Corned Beef X X X X X X

Beef & Guinness Stew X X X X X

Pork Chop Flamande (Chop Only) (Chop Only) (Chop Only) (Chop Only) X X (Chop Only) (Chop Only)

Roast Chicken X X

Baked Fish X X

Savoury Minced Beef X

Savoury Minced Chicken X

Minced Pork – in Apple Gravy

X

Minced Lamb Stew (1 potato only) X

Homemade Beef Burger – Lyonnaise Sauce

X X (No Sauce) (No Sauce)

Minced Beef Lyonnaise X

Flaked Fish in White Sauce

Low Fibre Coeliac

LUNCH

MATER MISERICORDIAE HOSPITAL – MAY 2010

White Card Cardiac Diabetic Renal No Added Salt Soft Minced & Moist

White Card Cardiac Diabetic Renal No Added Salt Soft Minced & Moist Low Fibre Coeliac

Chicken Pancakes X

Chicken Curry (Renal Curry) (Renal Curry) X X (Coeliac Curry Only)

Beef Burger Onion Sauce, Sauté Potatoes

(burger with side salad only)

(burger with side salad only)

(burger & tom.) X (Burger & Sauté Potatoes Only)

X

Sausages Beans & Sauté Pot.

(no sausages) (no sausages) X (no sausages) (no sausages) (No Beans) (no sausages)

Battered Cod & Beans X X (No Beans) X X X (No Beans) X

Tuna Mayo & Sauté Potatoes

(With Side Salad No Sauté Pot.)

Ham/Cheese Quiche & Sauté Pot.

X X X X X

Beef Bolognaise & Rice

X

Cheese/Egg Salad X X X (Meat Cheese Egg Only)

(No Coleslaw)

Bacon Saus. Scram Egg & Tom.

X X X X X X (No Tomato) (No Sausages)

Scrambled Egg Waffle & Beans

(No Waffle) (No Waffle) (Scr. Egg Only) (No Beans) (No Waffle)

Chicken Salad (Renal Salad) X X (Meat Cheese Egg Only)

(No Coleslaw)

Lasagne & Sauté Potatoes

(lasagne with side salad only)

(lasagne with side salad only)

(lasagne only) (lasagne with side salad only)

X X

Minced Chicken White Wine Sauce & Sauté

(With Rice No Sauté Pot.)

Sausage Rolls Peas & Tomato

X X X X X X (Sausage Roll Only) X

Shepherds Pie (Tea Recipe)

(with side salad) (with side salad) (shep pie only) (with side salad) (with beans) (with beans) (shep pie only) X

Plain Omelette & Beans

X (No Beans)

Poached Cod & Side Salad

X X (Cod Only) (Cod Only)

Southern Fried Chicken & Sauté

X X X X X X X

Salmon White Sauce & RiceBeans & Sauté Potatoes

X (No Beans)

TEAS

MATER MISERICORDIAE HOSPITAL – MAY 2010

White Card Cardiac Diabetic Renal No Added Salt Soft Minced & Moist Low Fibre Coeliac

Milk Puddings X X X (Ambrosia Custard

Or Rice Only)

Blackcurrant Cheesecake

X X X X X

Fresh Fruit Meringue (No Cream) X X X X X X

Sherry Trifle X X X X X X X

Strawberry Mousse X X X

Fresh Cream Slice X X X X

Fruit Gateaux X X X X X

Fruit Cocktail X X X X

Chocolate & Coffee Cream

X X X X

Chocolate Eclairs X X X X X

Jelly & Ice Cream (Jelly Only No Ice-Cream)

X X

Diet Jelly X (Only If Diabetic) X (Only If Diabetic) X (Only If Diabetic) (Only If Diabetic)

Puree Fruit (With Cream) (No pineapple)

Fruit Yogurt X X (No Banana Or Rhubarb Flavour)

X

Diet Fruit Yogurt X X

Petit Filous (for green cards)

X X X X X

DESSERTSMATER MISERICORDIAE HOSPITAL – MAY 2010

Promoting good nutritional care in hospital

AcknowledgementsCatering DepartmentHousehold StaffDepartment of Nutrition and DieteticsDepartment of Speech and Language Therapy

“Food is your medicine – hence let medicine be your food”


References

• Food and Nutritional Care in Hospitals. Guidelines for preventing Under- nutrition in Acute Hospitals August 2008• Delivering Nutritional Care Through Food and Beverage Services. A Toolkit for Dietitians December 2006• The McCance and Widdowson’s The Composition of Foods book series, the sixth summary edition 2002


Standardised Recipes and Diet Specific Menu Cards Presentation by: Barbara Gillman Clinical...

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