Many elderly in today’s society spend some length of time in a hospital setting. This score is more aimed towards those patient’s who have some degree of disability. The term disability is being used very generally and the patient’s only problem may be poorly fitted dentures; however this type of patient may be malnourished and it’s important that we recognize this. The elderly may become immobile and therefore may become malnourished. A patient may have mild dementia and may merely forget to eat. These points are important and need to be recognized when considering what types of “roadblocks” go into the patient eating properly.
There are many obvious factors which affect one’s nutrition. A diet filled with lots of sugar and fats is clear to anyone of it’s detrimental affects. What may not be so obvious are several other factors. Dementia is important because sufferers may forget to eat entirely or they may not be able to recall what exactly they ate. How are they able to balance their meals? Arthritis can affect patient’s in many ways. It can cause tremendous pain while moving, rendering a patient relatively immobile. Perhaps the patient has arthritis in their hands which makes it incredibly difficult to eat without pain; hence the patient does not eat. Many elderly are on stool softeners and some may take too much which can lead to diarrhea; this can lead to numerous nutrient deficiencies. Once the unrecognized factors are determined, this needs to be explained to the patient how they can and will affect their nutritional status.
The King Fund report established that hospital patients are malnourished. Malnourishment puts patients at risk for developing further illness in addition to healing at a much slower rate. Pressure ulcers in particular are a very serious problem which patients can develop while in a hospital and nutrition is one of the factors affecting the rate of development of these ulcers.
To help save time and work with greater efficiency, many of the factors used to determine the Waterlow score are used to calculate the Burton Score. The patients are also asked 3 questions and these questions aid in determining the Burton Score.
Though the Burton Score is determined using the above mentioned factors; that list is not exhaustive. Each factor is assigned a certain number of points and then that patient’s score is tallied. Depending on the score depicts the patient’s nutritional status.
In the first study, the registered dietician evaluated the patient and concluded their nutritional status. The Burton score was also calculated for that patient and the results in both instances were highly associated.
Matt Richardson<br />(Look to notes under slide to read what is to be said about slide)<br />Burton Score<br />
Purpose of Score<br />This score was created to assess the nutritional status of patient’s in a hospital setting.<br />Not uncommon that patients, especially elderly have spent time in a hospital or related facility.<br />Their nutrition status may have altered during their hospital stay, which is important to know.<br />
Explanation to Patients<br />Patients understand certain factors affect nutrition<br />Such as:<br />What you eat<br />How much you eat<br />However, some factors fly under the radar<br />Such as:<br />Dementia<br />Arthritis<br />Diarrhea<br />Must recognize and make patients aware of factors affecting their nourishment<br />
Development of Tool<br />King Fund Report<br />Report on malnourishment in hospitals<br />Burton Score utilizes data from the Waterlow score<br />Waterlow score<br />Risk for developing pressure ulcers<br />Factors determining Waterlow Score:<br />Sedentary state<br />Nutritional status<br />Demographic<br />Stature<br />(Link Below will show scoring card)<br />http://www.judy-waterlow.co.uk/downloads/Waterlow%20Score%20Card-front.pdf<br />
Development of Tool continued<br />Determining the Burton Score<br />Utilize certain data from Waterlow Score<br />Build/Weight for height<br />Skin Type<br />Malnutrition screening tool<br />Tissue Malnutrition<br />3 additional questions:<br />Patients ability to eat (i.e. ill-fitting dentures)<br />Any symptoms affecting nutrition (i.e. diarrhea, vomiting)<br />Unintentional weight loss in last 3 months<br />
Purposed Mechanism<br />The Burton Score utilizes:<br />Diet<br />Activity level<br />Ability to eat<br />Demographics<br />Smoking status<br />All of above factors are necessary to determine in order to assess nutritional status.<br />
Safety of Use<br />The Burton Score is incredibly safe.<br />No adverse affects could be found in determining score.<br />
Case studies, Testimonials, Methods of Marketing<br />No case studies could be found regarding this particular score.<br />
Literature Review<br />The Burton Score was highly associated with the assessment of a registered dietician.<br />The Waterlow Score and Burton Score were highly associated, however the Burton score was more specific and indiciated malnourishment in certain patients the Waterlow Score did not.<br />
Patient Selection Criteria<br />This score does not have to be used for any particular population<br />However, is intended to be used for elderly or patients who’ve recently spent time in a hospital.<br />Younger and even middle aged patients who are relatively healthy are not ideal participants for this score.<br />These patient’s would most likely appear “well nourished” due to lowered standards to account for the intended unhealthier subjects.<br />
Conclusion<br />This Burton Score should be used for patients. For optimal function of the score, the patients should however has spent several weeks in a hospital.<br />As stated in previous slide, younger, healthier subjects should utilize other assessment tools unless they’ve recently spent time within a hospital (as a patient)<br />
References<br />Green, S.M., Watson, R., Nutritional screening and assessment tools for use by nurses: a literature review. Journal of Advanced Nursing, 50(1), 69-83<br />Russell, L., Malnutrition and pressure ulcers: nutritional assessment tools. British Journal of Nursing, 2000;9(4), 198-204<br />Russell, L., Taylor, J., Brewitt J., Ireland, M., Reynolds, T., Development and validation of the Burton Score: a tool for nutritional assessment. J Tissue Viability, 1998 Oct;8(4), 16-22.<br />