PatientMealIntakeRecord
WhatdoweknowfromtheNutritionCareinCanadianHospitalsstudy(2010-2013)?• 45%ofpatientsadmittedtoCanadianhospitalsaremalnourished.• Foodintakeof50%orlessextendslengthofhospitalstay,eveninwell-nourished
patients.• 75%ofmalnourishedpatientsweremissedbycurrentdietitianreferralprocesses.
WhatisthePatientMealIntakeRecord?Itisanewformforrecordingpatientmealintakeandfollow-upovera7-dayperiod.
Whydoweneedit?• Tomakeiteasierforstafftomonitorandidentifytrendsinpatientmealintake.• Toincorporateaprocesstoidentifybarrierstopatientfoodintakeandthenecessary
follow-upcorrectiveaction.• IntegratedNutritionPathwayforAcuteCare(INPAC)thatisbeingimplementedon
N3WaspartoftheMore-2-Eatresearchstudyuseschangesinpatientfoodintaketodeterminenutritioncarestrategies/practicespertinenttothepatient.
Whatistheprocessforrecordingpatientmealintake?• At admission andweekly thereafter, aPatientMeal IntakeRecord is posted for all
patientsontotheirroomdoor.• Whenpickingupthepatienttrayaftermealtime,thehealthcareaide(orotherunit
staff):ü Willassessthetrayforpercentage(%)offoodconsumed
(canmakereferencetothe“AssessmentofPatientFoodIntake”posterintheroom)ANDwritethe%onthePatientMealIntakeRecord.
ü Willaskthepatienttwoquestionsifmealintakeis50%orless:Isyourappetitelessthanusual?ANDDoyouhavemealtimechallenges?
Ifpatientanswers“Yes”toeitherquestion,staffwillinquirefurtherwithpatient/familytodeterminecause(s),writecorrespondinglegendnumber(orothercomment)ontheRecordandinitial.
ü Willtakenecessarycorrectiveaction,ifapplicable,toimprove/solvetheproblem,writethecorrespondinglegendnumber(orothercomment)ontheRecordandinitial.
Rev - February, 2017
Arethereanytipsthatwillhelpmecompletethepatientmealintakerecord?
• Whenselectingastandardmeal intake%value(ie0,25,50,75,100%),choosethevalueclosest totheassessed intake. Forexample, ifpatientonly tooka fewbites,record“0”.Ifpatientonlyleftafewbitesonthemealtray,record“100”.Youdonotneedtorecordthepercentagesymbol.
• IfthepatientisNPOforthemeal,write“NPO”intheIntake%columnandnot“0”.• Whenassessing%ofmealconsumed,includeallfoodandfluidsonmealtray
(exceptoralnutritionalsupplements).• Give lessemphasis to the intakeof tea, coffee and soup,as these foodsgenerally
havetheleastnutritionalvalue.• Intakeoforalnutritionalsupplements (ONS)suchasEnsure®orBoost®shouldnot
beincludedinthemealintake%.Ifasupplementisconsumedatmealtime,reportitbywriting,forexample,“ONS–50”.Usethesamestandard%’sasformeals.
• If the patient does not knowwhat “mealtime challenges”would include, you canprovidesomeexamples(aslistedinthelegendontheRecord)tocreatediscussion.
• AClinicalDietitianreferralshouldbesentifpatientintakeis:50%orless,foratleast2mealsperday,for3consecutivedays.
• If patient continues to havemeal intake that is 50% or less and the dietitian hasalreadybeenconsultedandcompletedanassessment,donotsendanewreferral.Instead,under“ActionTaken”column,write“RDfollowing”.
• Refertothespecific“GuidelinesforUse”onpage2oftheRecord.
Whenwillthenewformbeavailableforuse?N3W,participatingintheMore-2-Eatresearchstudy,willbetrialingthenewformforonemonthstartingOctober17,2016.
CanIprovidefeedbackonthenewform/process?WhatifIhavequestions?Yes.Afterthefirst2weeks,therewillbeareviewcompletedandstaffinputwillberequested.Ifyouhaveanyquestionsduringthetrial,contactadietitian(ChelsaMarcell,StephanieBarnes,orDonnaButterworth),theN3WclinicalmanagerorFamilyMedicineprogrameducator.
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