Nutrition values of patients at a Hospital

2012-07-05T10:59:00.001-07:00

Abstract:

Introduction:

Undernourishment has been documented as a major problem among hospitalized patients for many years. It is evident that patient’s food intake is deficient during hospitalization, however their nutrition and energy intake can be increased significantly by optimizing the nutritional care using available hospital foods services(1-4). Furthermore, illness and hospitalization are frequently linked with negative energy balance and further declination in nutritional status of the patients. About 20%–50% of patients in hospitals are found at risk of under-nutrition. The number of such condition varies depending on clinical condition and clinical setting (2, 3, 5). A huge chunk of these patients are at risk of malnutrition during hospital stay. This is because of the clinical condition psychological effect of patient, food intake is decreased which in turn cause low intake of energy and ultimately of patients sign up to under-nutrition (6, 7). Such overlooked mater could lead to prolong stay in hospital, poor prognosis of diseases, increase morbidity and mortality among hospitalized patients(8). Studies have documented the distinct association of nutrition and health impairment at a cellular, physical and psychological level. This impairment is dependent on many factors, including the patient‘s sex (gender) age, gender, type and duration of illness, and current nutritional intake. Insufficient nutritional intake would lead to different clinical consequences such weight loss, anemia, hypo-albuminemia, vitamin deficiencies, increased sepsis, impaired wound healing, impaired muscle function & strength, and increased mortality(8-10). It also increases the risk of pressure ulcers (bedsore), infection, decreases nutrient intestinal absorption, alters thermoregulation and compromises renal function(11, 12). All these issues combined indirectly increase hospital costs associated with treating the patient, secondary to the management of their primary medical reason for admission(1, 11).

The nutritional needs of ized patient vary from individual to individual and it also varies among patient’s clinical conditions. For instance patients who suffer from heart related problems are often advised to follow a special, low fat diet that is high in vitamins, mineral and certain nutrients(13, 14). Similarly for diabetic patient food are advised according to the intensity and type of diabetics(15). Some time the nutrition plan is made according to the blood glucose level(16). In the same way the caloric requirements of different pediatrics patients moves on to a breakdown of the specific nutrients required(17). It then progresses to a detailed description of the nutritional modalities for delivery of nutrition to pediatric patients. Question arise about the value does a foods contain; for example an 8-oz glass of milk, a 3-oz slice of cooked meat, an apple, a slice of bread. What food values does each contain? How much cooked meats will a pound of raw meat yield? How much protein should a healthy child and adult should get each day?

It is apparent that every patient has different dietary requirements, and what's good for one person may be harmful for another. Thus good nutrition is very important and it should be looked on as an integral part of the treatment along with medication.

Such consequences could be prevented through optimization of the nutritional care using available hospital foods services. The result will be very fruitful if this is accompanied by screening of patient, prescription of nutritional plan and monitoring by an expert nutritionist. Therefore dietitian play an important role in this regards. After initial consultation with the dietitian, one will have their own individual diet which will be reviewed and changed when necessary.

Keeping the importance of nutrition, RMI have established a fully fledged nutrition department.

Patient Food and Nutrition Services at the Hospital provides exemplary hospital food services and medical nutrition therapy for patients. Apart from normal patient food and nutritional service, special consultation is made by expert dietitian when a case is been referred by physician. This article is mainly focus on assessment of dietary value of those patients with a define diagnoses and been referred by physician for nutritional therapy.

Aim of study

This study aimed to evaluate the nutritional values of individual patients with different clinical conditions consecutively admitted as inpatients to a Hospital, Pakistan between June and August 2011.

Objectives:

1. To determine the nutritional value of individual patient with specific clinical condition admitted in RMI during June and August 2011.

2. To categories different prescribed diets with diseases of patents admitted at RMI during June and August 2011

MATERIAL AND METHODS:

Study setting

This study was conducted at a Hospital. It is 300 bed hospital acts as premiere health care center of the region. In addition to complex cardiology and cardiac surgery procedures, it provides facilities in almost all major medical and surgical specialties like General Surgery, Laparoscopic Surgery, Plastic Surgery, ENT, Orthopaedic, Thoracic, Neurosurgery, Urology, Gynaecology & Obstetrics, Gastroenterology, Chest Diseases, Nephrology, Neurology, Dermatology, Paediatrics and General Medicine.

Study Design:

This was a prospective study on the nutritional Value of patients. The study started in June to August 2011. During this period 60 referred patients have been examined for the dietary plan/prescription. Data were gathered on regarding to provide dietary therapy on a check list designed under consultation of expert dieticians.

Study Population:

§ Those patient included in the study who have been referred by physician for dietary therapy/consultation

§ Patients who follow the protocol

Inclusion and exclusion criteria

§ Patients who don’t follow the protocol

Study Period

The study was conducted during the month of June, July and August 2011. During this three month period activities undertaken included: data collection, analysis, making inference about the result and providing recommendations based on study findings.

Sampling Strategy

As we were including all those patient who were referred by the physician, thus universal sampling technique was used to cater all the patients at RMI who required dietary therapy/consultation

Data Collection

Data were collected using chick list formulated according the special menu of food and nutrition services at RMI. The questionnaire/data collection check list was made under the consultation of senior dieticians. Data collection was carried out over the period of two months.

Data collection process

Apart from principal investigator, a senior dietician conducted the survey as co-investigator. The dietician was well competent and had completed her M.Phil in nutrition with five year experience in RMI.

Data Analysis

Descriptive statistics

After collection of data regarding the nutritional values of patients data were analyzed SPSS Version 15 and Microsoft excel 2007. Later on the average and mean was calculated for continues/Numeric data and frequency and percentages were calculated for categorical and nominal data.

Diet and Nutrition