Welcome to the second Nutritional Assessment Bulletin produced by HEFT Library Services. This bulletin
is produced to support the VITAL for nurses core skills programme developed in the Trust. This issue
features articles published in the past four weeks.
Dignity and nutrition inspection programme
The Care Quality Commission has published the next batch of reports from the dignity and nutrition inspection
programme. This programme intends to look at 100 NHS trusts, and focuses on whether people are treated with
dignity and respect and get food and drink that meets their needs. Further inspection reports will be published
at weekly intervals over the course of the summer. A national report into the key findings will be published in
Impact of protected mealtimes on mealtime
environment and nutrient intake in hospital patients
Journal of Human Nutrition and Dietetics. June; 24(3) p. 279-280
The aim of this observational before versus after service evaluation was to compare mealtime environment and
nutrient intake pre and post Protected Mealtimes (PM) implementation in an acute hospital trust. The findings
highlight the need for an evidence based PM implementation method which produces measurable improvements
in all PM objectives and so enabling a reliable measure of the impact of PM on nutritional and clinical outcomes.
A service review of dietetic input for chronic
obstructive pulmonary disease patients on long-term
oral nutritional support
Journal of Human Nutrition & Dietetics. June; 24(3) p.302-303
Due to current demands on dietetic services in Scotland, this retrospective case review looked to explore the
number of dietetic reviews provided and the consequent change in nutritional status in a group of COPD patients.
Comparison of screening tools in patients undergoing
Journal of Human Nutrition & Dietetics. June; 24(3) p.282-283
Subjective Global Assessment (SGA) had been recommended by the Renal Association as an appropriate
nutritional screening tool for detecting malnutrition in haemodialysis patients. The aim of this study was to assess
patients using three tools, these included SGA (as the gold standard), PG-SGA, and the Malnutrition Universal
Screening Tool (MUST).
Malnutrition and nutritional care practices in hospital
wards for older people
Journal of Advanced Nursing. April; 67(4) p.736-746
This paper is a report of a study conducted to gain a better insight into the current nutritional care practices
in Belgian hospital wards for older people, and to study the association between these practices and the
prevalence of malnutrition. In 2007, a cross-sectional survey was carried out in a representative sample of
Belgian hospital wards for older people. In total, 2094 patients from 140 wards for older people were included.
The overall prevalence rate of malnutrition in wards for older people was 319%. Nutritional care practices such
as nutritional screening and assessment, use of a standardized screening instrument and a nutritional protocol
were suboptimal. Multilevel analysis revealed that ward characteristics explained for 91% whether a patient was
malnourished or not. None of the registered nutritional care practices could explain a patients individual risk.
Available in fulltext at Ovid
Nutrition Management for the Patient Requiring
Prolonged Mechanical Ventilation
Nutrition in Clinical Practice. June; 26(3) p.232-241
Patients requiring prolonged mechanical ventilation are often medically complex and present with a wide range
of pulmonary conditions, including neuromuscular diseases, chronic pulmonary diseases, and chronic critical
illness. These patients present the nutrition support professional with many challenges. However, accurate
nutrition assessment, timely and effective nutrition interventions, and careful monitoring will help patients meet
their medical and nutrition goals.
Identifying the factors that influence energy deficit
in the adult intensive care unit: a mixed linear model
Journal of Human Nutrition & Dietetics. June; 24(3) p.215-222
Critically ill patients frequently receive inadequate nutrition support as a result of under-feeding or overfeeding.
Malnutrition in intensive care unit (ICU) patients is associated with increased morbidity and mortality. This study
aims to identify the significant factors that influence energy deficit in the ICU. Results show that efforts to initiate
feeding as soon as possible and minimise interruptions to feeding may reduce energy deficits in certain vulnerable
Nutrition support in surgical patients with colorectal
World Journal of Gastroenterology. April; 17(13) p.1779-1786
The aim of the study was to review the application of nutrition support in patients after surgery for colorectal
cancer, and to propose appropriate nutrition strategies. A total of 202 consecutive surgical patients admitted
with a diagnosis of colon cancer or rectal cancer from January 2010 to July 2010, meeting the requirements
of Nutrition Risk Screening 2002, were enrolled in the study. Laboratory tests were performed to analyze the
nutrition status of each patient, and the clinical outcome variables, including postoperative complications, hospital
stay, cost of hospitalization and postoperative outcome, were analysed. The study concluded that appropriate
and moderate nutritional intervention can improve the postoperative outcome of colorectal cancer patients.
Available in fulltext at EBSCO Host
Assessment of food intake in hospitalised patients: A
10-year comparative study of a prospective hospital
Clinical Nutrition. June; 30(3) p.289-296
A food quality control and improvement permanent process was initiated in 1999. To evaluate the food service
evolution, protein-energy needs coverage were compared in 1999 and 2008 with the same structure survey in
all hospitalised patients receiving three meals per day. The results suggested that oral nutritional supplements
(ONS) consumption is associated with a lower risk of underfeeding in hospitalized patients.
Effect of nutrition on wound healing in older people: a
British Journal of Nursing. June 2011; 20(11) (S4-S10 supplement)
In this tissue Viability Supplement nutrition and wound healing are discussed and also highlights the importance
Available in fulltext at EBSCO Host
The immunomodulating enteral nutrition in
malnourished surgical patients - A prospective,
randomized, double-blind clinical trial
Clinical Nutrition. June; 30(3) p.282-288 The immunomodulating nutrition was supposed to reduce the incidence
of complications in surgical patients. Many authors have questioned its value and this study assesses the impact
of enteral immunonutrition in the postoperative period.
Nutrition in the Stroke Patient
Nutrition in Clinical Practice. June; 26(3) p.242-252
This article reviews the evaluation and treatment of dysphagia, use of specialized nutrition support, strategies
for weaning enteral tube feedings, and the impact of nutrition on quality of life in the stroke patient population.
Short-term individual nutritional care as part of routine
clinical setting improves outcome and quality of life in
malnourished medical patients
Clinical Nutrition. April; 30(2) p.194-201 Short-term individual nutritional care as part of routine clinical setting
improves outcome and quality of life in malnourished medical patients.
Symptoms associated with dietary fiber
supplementation over time in individuals with fecal
Nursing Research. June; 60(3 Suppl) p.S58-67
There isn't much knowledge about adverse symptoms from fiber supplementation available. Patients with fecal
incontinence experience a variety of GI symptoms over a period of time. The symptom severity and emotional
upset appear to influence fiber tolerance. Supplements seem overall to be well tolerated.
Assessment of nurses nutritional knowledge regarding
therapeutic diet regimens
Nurse Education Today. February; 31(2) p.192-197
Metabolic diseases and cardiovascular disease (CVD) can be managed well with dietary education and
modification. However, it has yet to be established whether nurses have sufficient knowledge to impart
appropriate nutritional counselling to patients with these diseases. This study involved 506 nurses working at
Asan Medical Centre, Samsung Medical Centre, and Seoul National University Hospital between March and
May, 2006.The questionnaire comprised of 42 diet-related questions pertaining to diabetes, obesity, and CVD.
Results suggest that there is an urgent need to update the contents of nutrition education for nurses to reflect
the current changes in the Korean diet and the increasing incidence of metabolic diseases and CVD.
Available in fulltext at EBSCO Host EJS and Elsevier You will need to register (free of charge) with Science
Direct the first time you use it.
A pilot study of the effect of a nutrition education
programme on the nutrition knowledge and practice of
Journal of Human Nutrition & Dietetics. June; 24(3) p.300
Nursing staff from the acute hospital setting completed pre-training questionnaires and from this a Positive
Nutrition Education Programme was devised educating nursing staff on nutrition and how to utilise Malnutrition
Universal Screening Tool (MUST). A post training questionnaire was then completed, on the same wards, one
month following training. The maximum achievable knowledge score was 31 for both questionnaires. The nutrition
knowledge, practice and awareness were analysed using quantitative and qualitative descriptive analyses; a chi
squared test was used to look at the effect of pre education.
Multiple sources – websites, journals and healthcare databases – have been searched for evidence published
in the last four weeks. For further information please contact [email protected] or ext 45195
Please login with your Athens ID on www.evidence.nhs.uk ‘before’ 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 under ‘Electronic Forms’ menu. Kindly 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 HEFT Library
website www.heftlibrary.nhs.uk under the ‘Publications’ menu.