Welcome to the January 2013 Nutritional Assessment Bulletin produced by the HEFT Library
Services. This bulletin is produced to support VITAL for Nurses core skills programme developed
in the Trust. This issue will highlight evidence published in the previous quarter. Full text articles
can be accessed with your HEFT Athens ID.
Organisation
Appropriate protein provision in critical illness: a systematic and narrative review
American Journal of Clinical Nutrition, Sept 96(3) p.591-600
Meta analysis of clinical trial data to determine safe levels of protein provision for critically ill patients. Results
suggest that current levels are too low for optimum nutrition, but more research needs to be done.
Available from Free Access Content in American Journal of Clinical Nutrition
Cost-effectiveness of nutritional intervention on healing of pressure ulcers
Clinical Nutrition, Dec. 31(6) p.868-74
Small randomised controlled trial on the effectiveness of nutritional interventions at reducing the healing-time of
pressure ulcers compared to conventional methods, and an analysis of the cost-effectiveness of this approach.
Dehydration in stroke patients admitted to hospital
Nursing Times 108(42) p.23
Overview of research into the rate of dehydration incidents in stroke patients, with commentry on assessing
hydration status on entry to hospital and throughout the stay. The subsequent effect of dehydration on outcomes
is also discussed.
Available in fulltext from Nursing Times at ProQuest
Get on course for nutrition.
Nursing standard Sept 27(1) p.64
This paper describes a training event for BSc Nursing students at Birmingham University. The main focus is the
provision of nutritional products and gave delegates the opportunity for networking.
available in fulltext from Nursing Standard at ProQuest
Looks good enough to eat.
Nursing Times, Oct. 108(42) p.27
Case study of picture-menus as a method for helping physically or cognitively disabled patients choose meals.
Available in fulltext from Nursing Times at ProQuest
New standards for hospital food
British Journal of Nursing, Nov, 21(20), p.1228-1229
The Department of Health has announced new standards for NHS hospital food. A set of basic principles covering
the quality of food, nutritional content and choice for patients will be backed up by new inspections led by patients.
The principles state that nutritious and appetising hospital food and drink is essential. Patients will get a choice
from a varied menu, including meals suitable for religious needs and all patients should have access to fresh
drinking water at all times, unless it contradicts clinical advice.
Available in fulltext from British Journal of Nursing at EBSCOhost
Using Rapid Spread to improve hospital nutrition.
Nursing Times, 16 October 108 (42) p.24-25
Rapid spread is a form of change management. This is one trust's experience of using this programme of change
to bring in and sustain evidence-based nutritional care, resulting in great improvements for patients.
Available in fulltext from Nursing Times at ProQuest
Screening
Estimation of protein requirements according to nitrogen balance for older
hospitalized adults with pressure ulcers.
Journal of the American Geriatrics Society, Nov. 60(11) p.2027-34
Nitrogen balance in older hospitalised patients was evaluated using a food weighing record and nitrogen excretion
from urine, faeces and wound exudate. Patients with severe pressure ulcers can require higher protein intakes
because of muscle protein hypercatabolism rather than direct loss from wounds.
Malnutrition self-screening by using MUST in hospital outpatients: validity,
reliability, and ease of use.
American Journal of Clinical Nutrition 96(5) p.1000-1007
Patient self-screening for malnutrition with the MUST tool is considered. Patients felt that the tool is acceptable,
user-friendly and reliable.
Available in fulltext from American Journal of Clinical Nutrition at Free Access Content
Recognition
Adequate oral fluid intake in hospitalized stroke patients: does viscosity matter?
Rehabilitation Nursing, Sep 2012, 37 (5), p.252-257
This study deals with fluid intake in three groups of patients following stroke: patients in the community, those
who had been hospitalized with a thin liquid diet and those hospitalized with a thick liquid diet. Patients in the
community fared better than the hospitalized at meeting the recommended standard of 1500ml/day. Conclusions
identified included failures in the preparation of thick liquid diets among factors affecting fluid intake in stroke
patients
Available in fulltext from Rehabilitation Nursing at ProQuest
Is there a difference in bloodstream infections in patients associated with ready-
to-use versus compounded parenteral nutrition?
Clinical nutrition, Oct. 31(5) p.728-34
Parenteral nutrition, which is widely used with critically ill patients, has been associated with bloodstream
infections. This is a retrospective review of a large patient database over a two year period. In conclusion, patients
receiving parenteral nutrition from premixed multi-chamber bags as opposed to the conventional compounded
preparation are significantly less likely to develop bloodstream infections.
Intervention
Feeding Tube Placement Errors and Complications
Nutrition in Clinical Practice, Dec. 27(6) p.738-748
Review of common mistakes made when placing enteral feeding tubes endoscopically, fluoroscopically or blindly.
Suggestions for their prevention and management are made.
How accurate are X-rays to check NG tube positioning?
Nursing Times. Oct. 108(42) p.14-16
Audit of the efficacy of radiology reports for checking the safe positioning of nasogastric tubes after insertion,
and recommendations for improvements.
Available in fulltext from Nursing Times at ProQuest
Impact of preoperative nutritional support on clinical outcome in abdominal
surgical patients at nutritional risk
Nutrition, Oct. 28(10) p.1022-7
Cohort study examining the effect of nutritional supplementation in preoperative abdominal surgical patients at
reducing postoperative hospital stay. The conclusion suggests nutritional support would be advantageous to
patients reporting high pain scores pre-operatively.
Available in fulltext from Nutrition at ProQuest
Nutritional requirements in acute kidney injury
Journal of Renal Nursing, Sept. 4(5) p.231-235
The article looks at recent changes in the management of nutrient requirements among patients suffering acute
kidney injuries. Points highlighted include managing energy, protein and potassium requirements, as well as
ensuring patients risking malnutrition due to their injuries are correctly identified.
Available in fulltext at Journal of Renal Nursing;
Optimal timing for the initiation of enteral and parenteral nutrition in critical
medical and surgical conditions.
Nutrition, Sept. 28(9) p.840-843
Comparison of studies looking at when it is appropriate to deliver enteral or parenteral nutrition in critically ill
patients. Enteral nutrition is now thought to be safer than previously imagined, and associated with improved
outcomes in patients. Early onset parenteral nutrition is not associated with similar benefits.
Available in fulltext from Nutrition at ProQuest
PEG feeding tube placement and aftercare
Nursing Times, Oct. 108(42) p.20-22
Guide covering the successful insertion of a PEG feeding tube, including patient selection and subsequent
nursing care.
Available in fulltext from Nursing Times at ProQuest
Recent developments in enteral feeding for adults: an update
British Journal of Nursing 21(18) p.1067-1067
Enteral feeding is recognised as a safe and effective way to provide nutrition for hospitalised patients. This article
is a literature review covering topical issues in this changing field, including common problems and developing
technologies.
Available in fulltext from British Journal of Nursing at EBSCOhost
Nursing Role
Caring for older people with dementia in hospital Part one: challenges.
Nursing Older People, Oct. 24(8) p.33-37
Research resulting from interviews with nursing students on placement in adult nursing environments. The
research identified issues which the student felt interfered with ideal nursing care, including patient nutrition and
supporting patients emotional needs
Available in fulltext from Nursing Older People at ProQuest
Available in fulltext from Nursing Older People at EBSCOhost
Enteral nutrition for feeding severely underfed patients with anorexia nervosa
Nutrients, Sept 4(9) p.1293-1303
Case study of successful controlled enteral feeding as a method of correcting even extreme cases of under-
nutrition, whilst avoiding both refeeding syndrome and underfeeding.
Available from Directory of Open Access Journals in Nutrients
Factors leading to discrepancies between prescription and intake of enteral
nutrition therapy in hospitalized patients.
Nutrition, Sept 28(9) p.864-7
An observational study into factors leading to a reduction in eneteral nutrition prescribed by a nutritional support
team.
Available in fulltext from Nutrition at ProQuest
Hourly rounding in a high dependency unit
Nursing Standard, Oct. 27(8) p.35-40
Evidence based preparations for the introduction of frequent rounding on a high dependency unit, as a means
of improving patient safety. A literature search and staff interviews contribute to the study.
Available in fulltext from Nursing Standard at ProQuest
Available in fulltext from Nursing Standard at EBSCOhost
New guidance on the insertion of balloon gastrostomy
Nursing Times, Oct, 108(42) p.18
Examination of national nursing guidelines related to insertion of feeding tubes.
Available in fulltext from Nursing Times at ProQuest
Nutrition and hydration.
Nursing standard, Sept. 27(2) p.45
As part of the Practice Profile series, this article reflects on lessons learned by a staff nurse working on an
orthopaedic ward with regard to assessing the nutritional status of patients and how to encourage good nutritional
practice.
Available in fulltext from Nursing Standard at ProQuest
Available in fulltext from Nursing Standard at EBSCOhost
Parenteral nutrition in the intensive care unit.
Nutrition Reviews, 01 November 2012, 70(11) p.623-630
Current thinking on parenteral feeding and enteral nutrition are considered along with issues around malnutrition
and other complications such as over feeding, hyperglycaemia, sepsis and fatty liver. The need for proteins,
carbohydrate, lipids and micronutrients is also discussed.
Available in fulltext from Nutrition Reviews at EBSCOhost
Permissive underfeeding versus target enteral feeding in adult critically ill
patients
Trials, 12 October 2012(191) p. 1745-1752
Randomised controlled trial comparing two methods for enteral feeding: target-calorific intake feeding and
permissive underfeeding, tracking all-cause mortality. Trial is ongoing to Nov 2013.
Available in fulltext from Trials at BioMedCentral
Available in fulltext from Trials at National Library of Medicine
Further Information
Multiple sources – websites, journals and healthcare databases – have been searched for evidence published in the last
three months.
For further information please contact [email protected] ext 45195 (Solihull Hospital)
Please login with your Athens ID on www.evidence.nhs.ukbefore clicking on any of the journal full text links in this bulletin
for seamless access.
To request articles where there is no full text link, please complete an online article request form available on HEFT Library
website www.heftlibrary.nhs.uk. Please note that there is now a charge of £1 for such requests.
For more information on how to register for Athens, access the Athens Registration leaflet via the HEFT Library
website www.heftlibrary.nhs.uk.