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NurChat November 8th Transcipt
 

NurChat November 8th Transcipt

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With one third of all patients coming into hospital at risk of malnutrition (Nursing Times 2011) it is more important than ever that we ensure nutrition of our patients remains high on the agenda. As ...

With one third of all patients coming into hospital at risk of malnutrition (Nursing Times 2011) it is more important than ever that we ensure nutrition of our patients remains high on the agenda. As Nurses we are all aware that “Good nutrition, hydration and enjoyable mealtimes can dramatically improve older peoples health and well being” (McWilliams 2008) and how important it is to consider nutrition when thinking of other aspects of care such as wound healing, medication, and susceptibility to infection. So with this in mind how can we identify these “at risk” patients at the point of admission?


But the care does not stop with assessing and identifying the patients who are at risk; what can we do practically to promote good nutrition especially to those who are most vulnerable? From ensuring that those who need assistance get assistance to promoting a good eating environment, ensuring that patients have the right equipment with which to eat and promoting the right calorie intake – how can nurses ensure that their patients are getting the right nutritional care?


Thanks goes to @KevinHamPlymUni for this discussion suggestion.


Click the picture to download a printable PDF for notice boards


Some suggested reading material is linked below – please feel free to add to this if you find something that others will find useful.


Third of hospital inpatients at risk of malnutrition (2011) Nursing Times


Assessing the benefits of a malnutrition screening tool McWilliams (2008) Nursing Times


Malnutrition Universal Screening Tool – BAPEN


Innovations: a nurse led, multi professional approach to nutrition (2008) Nursing Times


Nutrition Now (2007) Nursing Standard


Nutrition older people (2011) Nursing Standard

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    NurChat November 8th Transcipt NurChat November 8th Transcipt Document Transcript

    • AgencyNurse @MacMoomin hope your washing machine is ok !! #Nurchat 9:08 PMNov 8thnursiedeb RT @AgencyNurse: Thank you all, great conversation :-)) #Nurchat 9:08PM Nov 8th AgencyNurse @kathjlo Sorry to hear that ! You can catch up by reading thetranscript later - will let you know when its up ! #Nurchat 9:07 PM Nov 8thAgencyNurse Thank you all, great conversation :-)) #Nurchat 9:06 PM Nov 8th nursemaiden @AgencyNurse #NurChat night all! Home duties call! Thanks for greatsession again! 9:06 PM Nov 8thMcCandlish Really interesting converstation :) thank you #Nurchat 9:04 PM Nov 8thkathjlo #Nurchat sorry you lost me halfway through lol had wash dye from my hair!Got told today i look 43 ( Im 38) :( 9:03 PM Nov 8th bigdfaekillie I think the foremost thing should be informed choice as well as dignityand respect #nurchat 9:03 PM Nov 8th AgencyNurse RT @nursemaiden: #NurChat It doesnt all have to be down to money,its culture again, values etc? #Nurchat 9:03 PM Nov 8th AgencyNurse @gerrybolger You are right - however investment in the currenteconomic climate is not forthcoming !! #Nurchat 9:02 PM Nov 8thNurChat please enjoy the chat for as long as you like this evening, another greatNurChat thanks to you all :) #nurchat 9:02 PM Nov 8th
    • NurChat transcript will be up later, and download for next chat available soon.#nurchat 9:01 PM Nov 8th gerrybolger RT @nursemaiden: #NurChat It doesnt all have to be down to money,its culture again, values etc? 9:01 PM Nov 8th AgencyNurse @KevinHamPlymUni Thanks for suggesting a great subject #Nurchat9:01 PM Nov 8th nursemaiden #NurChat It doesnt all have to be down to money, its culture again,values etc? 9:01 PM Nov 8th gerrybolger @AgencyNurse Its about investing in quality not an overhead... goodnutrition & hydration pays for itself tenfold #Nurchat 9:01 PM Nov 8thMacMoomin #nurchat cheers @McCandlish good chat! 9:01 PM Nov 8thRT @NurChat: thank you all for tonights input, espcially @KevinHamPlymUni forthe topic and @newcrosshealth for supporting NurChat #Nurchat 9:01 PM Nov 8th Gaggyy @NurChat Gotta go! Lovely chatting to everyone tonight about #Nutrition!#NurChat 9:00 PM Nov 8th AgencyNurse @nursemaiden I so agree with you there !! Its the only way to nurse#Nurchat 9:00 PM Nov 8thKevinHamPlymUni #Nurchat thanks everyone for a great chat bye 9:00 PM Nov 8th NurChat thank you all for tonights input, espcially @KevinHamPlymUni for thetopic and @newcrosshealth for supporting NurChat #nurchat 9:00 PM Nov 8th
    • MacMoomin RT @nursemaiden: #NurChat I now vow never to allow any of mypatients experience the same thing. Dignity and respect, treat how u wish be treatedurself 9:00 PM Nov 8th JigsawHealth RT @gerrybolger IMHO training is only part of the problem, its aboutresources & values - adequate nutrition is key for recovery #nurchat 9:00 PM Nov 8th nursemaiden #NurChat I now vow never to allow any of my patients experience thesame thing. Dignity and respect, treat how u wish be treated urself 8:59 PM Nov 8th AgencyNurse @nursemaiden Yes it is , but how do we resolve this?? It all comesdown to cost - training, staffing, better food £££££ !! #Nurchat 8:59 PM Nov 8th NurChat almost closing time this evening, next chat 22nd Nov "effect of theenvironment on pt and health" #nurchat 8:59 PM Nov 8th nursemaiden #NurChat I witnessed my elderly father being cared for in acutehospital. It was an eye opener being on the other side of fence! 8:57 PM Nov 8th AgencyNurse @KevinHamPlymUni Yes we are back to fundamental care - soimportant to promote recovery and prevent complications #Nurchat 8:56 PM Nov 8th NotFromBolton @AgencyNurse Ahhh buts thats expensive #Nurchat 8:56 PM Nov8th NurChat RT @McCandlish: I have been fed, had my teeth brushed, been hoisted. andthink you need this to understand how to help pts. #nurchat 8:55 PM Nov 8th KevinHamPlymUni #Nurchat we try to instill the importance of the fundamentals ofnursing care before getting too involved with other roles 8:54 PM Nov 8th McCandlish I have been fed, had my teeth brushed, been hoisted. and think you needthis to understand how to help pts. #Nurchat 8:54 PM Nov 8th
    • nursemaiden #NurChat 8:54 PM Nov 8thMcCandlish RT @AgencyNurse: @NotFromBolton Yes if we were all robots !!! Butwe are human beings after all !! #Nurchat 8:54 PM Nov 8th AgencyNurse @bigdfaekillie Thats not good - when did we get too short staffed tonot ensure ppl are adequately fed and hydrated ? #Nurchat 8:54 PM Nov 8th AgencyNurse @NotFromBolton Yes if we were all robots !!! But we are humanbeings after all !! #Nurchat 8:53 PM Nov 8th bigdfaekillie @AgencyNurse yes, I think its down to staffing levels though #nurchat8:52 PM Nov 8th UKDietitian Thanks to all, sorry I have to go now, brilliant to hear all yourcomments. #nurchat 8:52 PM Nov 8th NotFromBolton #Nurchat NG tubes and a liquidator? Reduced cost and improvedperformance in one go #winning 8:51 PM Nov 8thAgencyNurse @bigdfaekillie On the wards ? #Nurchat 8:51 PM Nov 8thbigdfaekillie @KevinHamPlymUni as a second year student, I agree with you aboutthe theory side, unfortunately we dont see this in practice #nurchat 8:51 PM Nov 8th UKDietitian @AgencyNurse Brilliant to hear that! I should include that in mytraining, I make Drs drink Fortisips after all! #nurchat 8:50 PM Nov 8th KevinHamPlymUni “@gerrybolger: @KevinHamPlymUni Can they put it intopractice when they go into placement? #Nurchat” > Id be amazed if they couldnt8:50 PM Nov 8th
    • gerrybolger IMHO training is only part of the problem, its about resources (people &food) & values - adequate nutrition is key for recovery #nurchat 8:49 PM Nov 8th Gaggyy @AgencyNurse @UKDietitian Same here, I had to be fed and feed a kitchenstaff, as well as being hoisted! Was great #Nurchat 8:49 PM Nov 8th AgencyNurse @McCandlish your placement sounds like they have it sussed !!#Nurchat 8:49 PM Nov 8th McCandlish we have a nutritional link nurse who has developed a good resource forthe whole ward, and attends regular extra training herself #Nurchat 8:48 PM Nov 8th gerrybolger @KevinHamPlymUni Can they put it into practice when they go intoplacement? #Nurchat 8:48 PM Nov 8th nursemaiden @AgencyNurse #NurChat why do we always seem to go around incircles we have talked about this for years havent we! 8:48 PM Nov 8th AgencyNurse @UKDietitian I had some fabulous training that included being fed !!Interesting and recommended experience #Nurchat 8:47 PM Nov 8th KevinHamPlymUni #Nurchat we educate our students in theory and throughsimulation in the skills lab regarding nutrition 8:47 PM Nov 8th gerrybolger @AgencyNurse I agree QIPP is about prevention, not reaction &investing more in nutrition & hydration would also reduce LOS too #Nurchat 8:47PM Nov 8thnursiedeb @AgencyNurse You have hit the nail on the head there. #nurchat 8:47 PMNov 8th NurChat RT @AgencyNurse: @nursiedeb @gerrybolger mad that the NHS spend solittle on food but lots monitoring malnutrition!! #nurchat 8:47 PM Nov 8th
    • NurChat RT @UKDietitian:Most definitely! Our Trusts nutritional ward trainingruns on a rolling basis and is our best tool to help #nurchat 8:46 PM Nov 8th AgencyNurse @nursiedeb @gerrybolger mad that the NHS spend so little on foodbut lots monitoring malnutrition!! #Nurchat 8:46 PM Nov 8th gerrybolger RT @NotFromBolton: #nurchat People admitted to hospital are usuallyfairly Ill. This means they are in a maln… (cont) http://t.co/tlA5C2gX 8:46 PM Nov8th mikkywatt RT @McCandlish: I also dislike it when pts are able to feed themselves,slowly, but staff feed them to speed things ups. #nurchat 8:46 PM Nov 8th UKDietitian @NurChat Most definitely! Our Trusts nutritional ward training runs ona rolling basis and is our best tool to help #nurchat 8:46 PM Nov 8th NurChat RT @NotFromBolton: #nurchat People admitted to hospital are usuallyfairly Ill. This means they are in a malnourished state already. Feeding up is the game;) 8:45 PM Nov 8th Gaggyy @NurChat BASICALLY! imo, theres not enough staff, theres not enoughfunding, and theres not enough training. #Nurchat 8:45 PM Nov 8th gerrybolger @UKDietitian I agree facilities are necessary & they did have a variableseasonal locally sourced menu with dietican input #nurchat 8:45 PM Nov 8thNotFromBolton #nurchat People admitted to hospital are usually fairly Ill. Thismeans they are in a malnourished state already. Feeding up is the game ;) 8:44 PMNov 8th McCandlish I also dislike it when pts are able to feed themselves, slowly, but stafffeed them to speed things ups. #Nurchat 8:44 PM Nov 8thNurChat so are we saying that more training is needed ? #nurchat 8:44 PM Nov 8th
    • rc4gehr Giving the correct sized portions for pt, have seen overloaded plates whensmall have been requested. Can be off putting. #nurchat 8:44 PM Nov 8thUKDietitian @gerrybolger And this works best when you have a seasonal menu tomake the most of local foods at their best price #nurchat 8:44 PM Nov 8th nursiedeb RT @gerrybolger: & remember food & hydration is linked to many otherpreventable issues, ulcers, VTEs, falls and impacts of recovery - #nurchat 8:44 PMNov 8th mikkywatt @nursemaiden Definitely sitting, how off putting must it be to havesomeone stand over you shoving food in your mouth?! #nurchat 8:43 PM Nov 8th KevinHamPlymUni #Nurchat touché I worked in private sector and the quality offood is amazing 8:43 PM Nov 8th AgencyNurse RT @gerrybolger: & remember food & hydration is linked to manyother preventable issues, ulcers, VTEs, falls & impacts of recovery #Nurchat 8:43 PMNov 8th NurChat RT @gerrybolger: & remember food & hydration is linked to many otherpreventable issues, ulcers, VTEs, falls and impacts of recovery - #nurchat 8:42 PMNov 8th McCandlish #Nurchat oral hygiene is often forgotten, however we do have lots oftoothbrushes and toothpaste, and I try and make sure I remind my bay. 8:42 PM Nov8th UKDietitian @gerryblogger Very true, but if you dont have an onsite kitchen to cookit it still has to be reheated to be served! #nurchat 8:41 PM Nov 8th nursemaiden @AgencyNurse #NurChat I now work in independent sector quality offood excellent and hostesses to collect order and serve etc! 8:41 PM Nov 8th
    • KevinHamPlymUni #Nurchat perhaps oral hygiene could be a future topic? 8:41 PMNov 8thAgencyNurse @gerrybolger Yes SIT DOWN !! I agree !! #Nurchat 8:41 PM Nov 8th gerrybolger & remember food & hydration is linked to many other preventableissues, ulcers, VTEs, falls and impacts of recovery - #nurchat 8:41 PM Nov 8thnursiedeb @AgencyNurse I agree! Oral hygiene is so important! I better not get onmy high horse. I may fall off! #nurchat 8:40 PM Nov 8th mikkywatt Hear hear! RT @Gaggyy: @kathjlo @AgencyNurse I agree oral hygieneis always forgotten about!! SO ANNOYING! #nurchat 8:40 PM Nov 8th gerrybolger RT @nursemaiden: @gerrybolger#Nurchat its both quality of food andstaff to sit down and supervise feeding! Sitting and not standing!! 8:40 PM Nov 8th NotFromBolton @registerpatient Then its not a big enough problem then. #Nurchat8:40 PM Nov 8th gerrybolger On BBC Countryfile in the Midlands showed you can feed pts withlocally sourced highly nutritional food cheaper than chilled food #nurchat 8:40 PMNov 8th KevinHamPlymUni RT @nursemaiden: @gerrybolger#Nurchat its both quality offood and staff to sit down and supervise feeding! Sitting and not standing!! 8:39 PMNov 8th AgencyNurse RT @Gaggyy: @kathjlo @AgencyNurse I agree oral hygiene isalways forgotten about!! SO ANNOYING! #Nurchat 8:39 PM Nov 8thAgencyNurse RT @gerrybolger: @nursemaiden but the cost to the NHS withmalnourishment a poor food budget gas to be false economy?? #Nurchat 8:39 PMNov 8th
    • mikkywatt @gerrybolger @agencynurse @nursemaiden Remember reading it wasless than the budget for prisoners, not enough for good healthy food #nurchat 8:39PM Nov 8th nursemaiden @gerrybolger#Nurchat its both quality of food and staff to sit down andsupervise feeding! Sitting and not standing!! 8:39 PM Nov 8th AgencyNurse @bigdfaekillie add #nurchat to your tweets, then we can see you in thechat, suggest www.tweetchat.com to follow others tweets :) 8:39 PM Nov 8thGaggyy @kathjlo @AgencyNurse I agree oral hygiene is always forgotten about!!SO ANNOYING! #nurchat 8:39 PM Nov 8th UKDietitian @kathjlo In the good old days we had onsite kitchens cooking freshfood & ward kitchens for cooking snacks on demand. Sadly no more #nurchat 8:38PM Nov 8th gerrybolger RT @KevinHamPlymUni: #Nurchat research in 1970s show similarpercentages as today for malnourishment in hospitals 8:38 PM Nov 8th gerrybolger @AgencyNurse I believe so, maybe if we have any dieticans they couldadvise? #Nurchat 8:37 PM Nov 8th nursemaiden @AgencyNurse#Nurchat personally I would like to see wards havetheir own volunteers, there are many people willing to do this 8:37 PM Nov 8th AgencyNurse RT @KevinHamPlymUni: #Nurchat research in 1970s show similarpercentages as today for malnourishment in hospitals #Nurchat 8:37 PM Nov 8th kathjlo @AgencyNurse i think thats it we didnt have so much other stuff to do#nurchat 8:37 PM Nov 8thAgencyNurse @gerrybolger really, as little as that ? #Nurchat 8:37 PM Nov 8th
    • KevinHamPlymUni #Nurchat research in 1970s show similar percentages as todayfor malnourishment in hospitals 8:37 PM Nov 8th rc4gehr #nurchat hi Im Claire (Midlands) was late so have been lurking #nurchat8:37 PM Nov 8th AgencyNurse @kathjlo surely there have always been both underweight andoverweight pts, but did we use to have time to care?? #Nurchat 8:36 PM Nov 8th robertjgardner RT @nursemaiden: @AgencyNurse#Nurchat we used to have lots ofvolunteers in our A&E department, they were brilliant at making tea, gettingsandwiches etc 8:36 PM Nov 8th gerrybolger @nursemaiden Is the issue how much budget set to feed each patient in24 hours, isnt it something like less than £4 a day? #Nurchat 8:36 PM Nov 8thkathjlo @AgencyNurse ooh dont get me started on oral hygiene lol #nurchat 8:36 PMNov 8th nursiedeb RT @nursemaiden: @AgencyNurse#Nurchat we used to have lots ofvolunteers in our A&E department, they were brilliant at making tea, gettingsandwiches etc 8:35 PM Nov 8th kathjlo did we have these issues with nutrition in the good old days or is thissomething new lol? #nurchat 8:35 PM Nov 8th gerrybolger @mikkywatt For the record, its an approached used in one US hospital,it works for them for all harm risks #nurchat 8:34 PM Nov 8th AgencyNurse @nursemaiden thats excellent and just what is needed surely !#Nurchat 8:34 PM Nov 8th
    • NurChat RT @nursemaiden: @AgencyNurse#Nurchat we used to have lots ofvolunteers in our A&E department, they were brilliant at making tea, gettingsandwiches etc 8:34 PM Nov 8th AgencyNurse What about oral hygiene - I often see this go unnoticed as veryimportant !! Is this another time thing? #Nurchat 8:33 PM Nov 8th mikkywatt @gerrybolger Coloured nightwear? Think I would have issues with that,not sure it is very dignified. #nurchat 8:33 PM Nov 8th NotFromBolton @registerpatient Exactly, theres your problem. Now whats thesolution? #nurchat 8:33 PM Nov 8th nursemaiden @AgencyNurse#Nurchat we used to have lots of volunteers in our A&Edepartment, they were brilliant at making tea, getting sandwiches etc 8:33 PM Nov8th NurChat RT @nursiedeb: @NurChat One again I am astounded by the depth ofknowledge of nurchatters out there. What a way to learn! #nurchat 8:31 PM Nov 8th gerrybolger @agenc@AgencyNurse i agree its their approach hich works from them- similar to redtrays & jugs here #Nurchat 8:31 PM Nov 8th nursiedeb @NurChat One again I am astounded by the depth of knowledge ofnurchatters out there. What a way to learn! #nurchat 8:31 PM Nov 8thAgencyNurse RT @nursemaiden: @AgencyNurse I mentioned that to a hospital andwas told volunteers werent allowed to incase a patient choked??? #Nurchat 8:31 PMNov 8th kathjlo @nursemaiden @AgencyNurse yes i ve heard that too but our volunteers dohelp and are very good #nurchat 8:31 PM Nov 8th CaraSloss #nurchat MUST def only a small part of the big picture, overwt & underwtequally at risk, nutrition assistants massive help on wards! 8:30 PM Nov 8th
    • NotFromBolton #Nurchat Give people crap and then wonder why they are noteating? It doesnt add up. Would you eat it? 8:30 PM Nov 8th AgencyNurse @gerrybolger Sounds like a good idea , but not sure I would want to bethe pt in different coloured nightwear !! #Nurchat 8:30 PM Nov 8th UKDietitian @AgencyNurse We too have been told volunteers can only assist byopening packets/giving encouragement, not feeding! #nurchat 8:30 PM Nov 8thNurChat should we be sending the transcript to @jamieoliver tomorrow@notfrombolton? #nurchat 8:30 PM Nov 8th kathjlo @McCandlish as long as they have food hygiene certificates then thats fine#nurchat 8:30 PM Nov 8th nursemaiden @AgencyNurse#Nurchat I mentioned that to a hospital and was toldvolunteers werent allowed to incase a patient choked??? 8:29 PM Nov 8th gerrybolger In US (Parkland Hospital Texan) use coloured nightwear to identifyvulnerable patients #nurchat 8:29 PM Nov 8thMcCandlish Would volunteers be allowed? As visitors are not allowed to assist atmeals as far as I am aware. #nurchat 8:28 PM Nov 8thAgencyNurse RT @gerrybolger: @AgencyNurse The link to the proposed outcomemeasurement indicator is here http://t.co/EaNd1iKz#Nurchat 8:28 PM Nov 8thUKDietitian @AgencyNurse: Weve found adapted cutlery, plates & mugs havemade huge difference to some of our patients. #nurchat 8:28 PM Nov 8thGaggyy @NotFromBolton I quite like hospital food :P #Nurchat 8:28 PM Nov 8th
    • AgencyNurse @gerrybolger Great thank you :-)) #Nurchat 8:28 PM Nov 8th kathjlo @AgencyNurse couldnt agree more but i think because they are overweightthey are treated differently not classed as high risk #nurchat 8:28 PM Nov 8th McCandlish My current ward is very good at protecting meal times, doctors wererunning late on ward round one day but thats all ive seen #nurchat 8:28 PM Nov 8th gerrybolger @AgencyNurse The link to the proposed outcome measurementindicator is here bit.ly/rPiZTt #Nurchat 8:27 PM Nov 8th NotFromBolton #Nurchat But when is some one actually going to sort out the factthat hospital food is a massive contributory factor. Its awful #noexcuse 8:27 PM Nov8th AgencyNurse @nursemaiden What about mealtime volunteers ?? Would this help?#Nurchat 8:27 PM Nov 8thGaggyy RT @KevinHamPlymUni: #Nurchat also encouraging visitors to visit atmealtimes to help or encourage patients to eat 8:27 PM Nov 8th Gaggyy @mikkywatt @KevinHamPlymUni I have views for and actually againstprotected meal times. #Nurchat 8:27 PM Nov 8th nursemaiden @AgencyNurse#Nurchat I wish I knew, I agree with red tray andprotected time however its staff numbers to dependency issues? 8:26 PM Nov 8th mikkywatt @KevinHamPlymUni Does everyone obey the meal times though? Wehad them on my final placement but they still got disturbed #nurchat 8:25 PM Nov8th
    • NurChat RT @UKDietitian: #nurchat Just carried out yearly MUST Audit at ourTrust, now doing route-cause analysis as to why not completed. Suggestions to startus? 8:25 PM Nov 8th KevinHamPlymUni #Nurchat also encouraging visitors to visit at mealtimes to helpor encourage patients to eat 8:25 PM Nov 8th AgencyNurse @kathjlo Surely the idea is to promote a healthy balanced diet?#Nurchat 8:25 PM Nov 8thkathjlo obviously this whole debate makes you think a little differently #nurchat 8:25PM Nov 8th McCandlish I agree about older pts being left unable to feed themselves. It is veryfrustrating especially when wards are short staffed. #nurchat 8:25 PM Nov 8th AgencyNurse @nursemaiden I have similar concerns - what practical things can wedo to combat this ? #Nurchat 8:24 PM Nov 8th kathjlo i have had incidences where overweight patients may not be eating meals andit gets over looked because they arnt going to starve #nurchat 8:24 PM Nov 8th mikkywatt Me too RT @nursemaiden: #NurChat my concern is the elderly inhospital unable to feed themselves and food being left #nurchat 8:23 PM Nov 8th nursiedeb RT @AgencyNurse: RT @nursemaiden: #NurChat my concern is theelderly in hospital unable to feed themselves and food being left #Nurchat 8:23 PMNov 8th KevinHamPlymUni #Nurchat our local trust has protected mealtimes and the red traysystem 8:23 PM Nov 8th AgencyNurse RT @nursemaiden: #NurChat my concern is the elderly in hospitalunable to feed themselves and food being left #Nurchat 8:23 PM Nov 8th
    • UKDietitian #nurchat Just carried out yearly MUST Audit at our Trust, now doingroute-cause analysis as to why not completed. Suggestions to start us? 8:23 PM Nov8th AgencyNurse @KevinHamPlymUni That sounds like a very minimal approach - dothey get put on any weight loss programme? #Nurchat 8:23 PM Nov 8thNurChat thanks @Hhaylo, catch you soon :) #nurchat 8:22 PM Nov 8th Hhaylo #nurchat sorry, have to go. Thanks and will read transcript tomorrow, hopeyou all come up with some good solutions :-) 8:22 PM Nov 8thAgencyNurse Anyone aware of community drives to identify and help withmalnourishment ? #Nurchat 8:22 PM Nov 8th KevinHamPlymUni #Nurchat in my local trust if a patient is assessed as obese theinstructions is to give them a healthy eating booklet 8:21 PM Nov 8th nursemaiden #NurChat my concern is the elderly in hospital unable to feedthemselves and food being left 8:21 PM Nov 8th AgencyNurse @KevinHamPlymUni I agree we often forget the overweight pts -obesity has its own health implications #Nurchat 8:21 PM Nov 8th NotFromBolton RT @AgencyNurse: RT @nursiedeb I think that we need to realisepatients are often malnourished prior to admission. Its a huge prob in bariatric pts#Nurchat 8:21 PM Nov 8th Gaggyy @KevinHamPlymUni Agreed! We shouldnt condone being size 0 OR sizesexy, SIZE HEALTHY all the way! #Nurchat 8:21 PM Nov 8th
    • kathjlo as likely to be as an underweight pateint. and yet we may even attempt toreduce intake in this patient group #nurchat 8:20 PM Nov 8th mikkywatt @Gaggyy Very true, was thinking of some of my older clients whostruggle to keep their trousers/skirts up when walking. #nurchat 8:20 PM Nov 8th AgencyNurse RT @McCandlish: Have NICE produced guidelines in over nutrition?#nurchat When I was looking recently I couldnt find any. #Nurchat 8:19 PM Nov 8th kathjlo @AgencyNurse @nursiedeb i think that its highly unlikely that a bariatricpatient would be considered as malnourished but are just #nurchat 8:19 PM Nov 8th nursiedeb @AgencyNurse I totally agree. Often the family is our greatest ally inprevent malnourishment #nurchat 8:19 PM Nov 8thKevinHamPlymUni #Nurchat most people in society are overweight or obese 8:18PM Nov 8th McCandlish Have NICE produced guidelines in over nutrition? #nurchat When I waslooking recently I couldnt find any. 8:18 PM Nov 8thAgencyNurse RT @nursiedeb I think that we need to realise patients are oftenmalnourished prior to admission. Its a huge prob in bariatric pts #Nurchat 8:18 PMNov 8th nursiedeb @NurChat also need to be aware that malnutrition isnt just caused by noteating. Not eating the rght variety offoods is the issue #nurchat 8:18 PM Nov 8th AgencyNurse @nursiedeb this is ridiculous - particularly when we are trying toencourage ppl to eat and gain weight #Nurchat 8:17 PM Nov 8th Gaggyy @mikkywatt But what about patients that favour baggy clothes? Or wearthem for hassle free dressing? #nurchat 8:17 PM Nov 8th
    • KevinHamPlymUni #Nurchat bariatric is the future 8:17 PM Nov 8th mikkywatt @NurChat Decent food that people actually want to eat, makes a hugedifference #nurchat 8:17 PM Nov 8thnursemaiden #NurChat hi sally from bristol sorry bit late 8:17 PM Nov 8th NurChat RT @KevinHamPlymUni: #Nurchat Must isnt great at assessing orsuggesting care for patients who are overnourished #nurchat 8:17 PM Nov 8th nursiedeb @NurChat I think that we need to realise patients are often malnourishedprior to admission. Its a huge prob in bariatric pts #nurchat 8:16 PM Nov 8th AgencyNurse RT @KevinHamPlymUni: #Nurchat Must isnt great at assessing orsuggesting care for patients who are overnourished #Nurchat 8:16 PM Nov 8th EmmaCarderRD @northwnutrition @McCandlish: MUST an assessment tool, not acare plan so just beginning of sorting out a pts nutritional needs... #nurchat 8:16 PMNov 8th mikkywatt Should be something in initial/ongoing nurse assessment about clothesfitting, people often come into hospital wearing 2 big items #nurchat 8:15 PM Nov8th AgencyNurse @gerrybolger Lol - that would be fab, but please dont rush on myaccount !! #Nurchat 8:15 PM Nov 8thGaggyy @NurChat More staff!!! :P #nurchat 8:15 PM Nov 8th KevinHamPlymUni #Nurchat Must isnt great at assessing or suggesting care forpatients who are overnourished 8:15 PM Nov 8th
    • nursiedeb @NurChat Pts. families are often keen to bring in food they know theirrelative will eat but are discouraged due to various regs. #nurchat 8:15 PM Nov 8th gerrybolger @AgencyNurse no, but can put up a page tonight if that would helphttp://t.co/s9ho6oYD will be the link give me 30 mins! #Nurchat 8:14 PM Nov 8thNurChat so what CAN be done to really tackle malnutrition in pts?? #nurchat 8:14PM Nov 8th kathjlo it is not a magic wand and does not replace the need for good nursing careand clinical observation #nurchat 8:14 PM Nov 8thgerrybolger MUST is also only suitable for adults #nurchat 8:14 PM Nov 8th northwnutrition RT @McCandlish: MUST is just an assessment tool, not a care planso its just the beginning of sorting out a pts nutritional needs... #nurchat 8:13 PM Nov8th AgencyNurse @gerrybolger do you hav details on your blog? #Nurchat 8:13 PM Nov8th gerrybolger RT @McCandlish: MUST is just an assessment tool, not a care plan soits just the beginning of sorting out a pts nutritional needs.. #nurchat 8:13 PM Nov 8th kathjlo Must is another piece of paper work put in place from the gods above so theycan say they are dealing with malnutrition! #nurchat 8:13 PM Nov 8th KevinHamPlymUni #Nurchat hi all Im Kevin lecturer in adult nursing in Plymouth8:13 PM Nov 8th
    • AgencyNurse @McCandlish I agree - its just the start needs to be followed throughwith good planning and most importantly implementation #Nurchat 8:13 PM Nov 8th NurChat RT @McCandlish: MUST is just an assessment tool, not a care plan so itsjust the beginning of sorting out a pts nutritional needs... #nurchat 8:13 PM Nov 8thgerrybolger Im happy to share what we did & it was developed with RCN, BDA,Water Uk & others but didn;t get uptake #nurchat 8:12 PM Nov 8thAgencyNurse @gerrybolger that sounds interesting #Nurchat 8:12 PM Nov 8th McCandlish MUST is just an assessment tool, not a care plan so its just the beginningof sorting out a pts nutritional needs... #nurchat 8:12 PM Nov 8thmikkywatt @AgencyNurse Absolutely, MUST score of 2-3, nothing done about it...Hard to do on some people though, poor historians #nurchat 8:11 PM Nov 8th nursiedeb RT @AgencyNurse: RT @MacMoomin: we use MUST but I agree.Sometimes it is paid lip service & not linked to care or real life problem solving forpts #Nurchat 8:11 PM Nov 8th gerrybolger ... but for some odd reason never got finally implemented because itneeded patient weight (as we also aligned it to hydration #nurchat 8:10 PM Nov 8thMacMoomin #nurchat back in a mo. Washing machine playing up! #darn 8:10 PMNov 8th Gaggyy @AgencyNurse Agreed! Great tool, but is it always followed? I dont thinkso... Is malnutrition more prevalent in geriatrics? #Nurchat 8:10 PM Nov 8thHhaylo @MacMoomin totally agree #nurchat 8:10 PM Nov 8th
    • gerrybolger @AgencyNurse I agree but only if we let it, we incorporated itsprinciples into a suggested nurse sensitive outcome indicator... #Nurchat 8:10 PMNov 8th AgencyNurse RT @MacMoomin: we use MUST but I agree. Sometimes it is paid lipservice & not linked to care or real life problem solving for pts #Nurchat 8:10 PMNov 8th Hhaylo @AgencyNurse Agree with paper exercise comment, snowed under withdocumentation! #nurchat 8:09 PM Nov 8th AgencyNurse @Hhaylo I like the addition of eyes and instinct - I think this is vital#Nurchat 8:09 PM Nov 8th MacMoomin #nurchat we use MUST but I agree. Sometimes it is paid lip service andnot linked to care or real life problem solving for patients. 8:09 PM Nov 8thpaulalouisexx #nurchat 3rd year nutrition and health student 8:09 PM Nov 8th Hhaylo #nurchat we use malnutrition screening tool, good if used effectively withdietetic support + eyes and instinct! 8:08 PM Nov 8th McCandlish MUST #nurchat done on admission, which then leads to a food plan forevery pt - red amber or green, and potentially dietician referral. 8:08 PM Nov 8th AgencyNurse MUST is a fabulous tool but all too often I see it being used only as apaper exercise #Nurchat 8:07 PM Nov 8th Gaggyy @NurChat Hey tweeps! Gage here :) An interesting topic! Mainly lurking ason my Blackberry! #Nurchat 8:06 PM Nov 8thAgencyNurse RT @NurChat: so tonight subject is nutrition- with 1/3 of pts at risk ofmalnutrition how can we identify those at risk #Nurchat 8:05 PM Nov 8th
    • northwnutrition Hi to #nurchat. Anne from wirral- dietitian. Trying to join in with aslowish connection 8:05 PM Nov 8th lisadietitian RT @NurChat: #nurses #nursing #nurseuk tonight at 8pm we arediscussing nutrition via #NurChat http://t.co/5lZxsTsJ 8:05 PM Nov 8thHhaylo #nurchat Hi, Hayley in Bristol 8:04 PM Nov 8thNurChat thanks to Kevin for tonight’s topic suggested from@kevinhamplymuni#nurchat 8:04 PM Nov 8thNurChat so tonight subject is nutrition- with 1/3 of pts at risk of malnutrition how canwe identify those at risk #nurchat 8:04 PM Nov 8thMacMoomin #nurchat Kate in Hampshire. Community perspective. 8:03 PM Nov 8thMcCandlish Student Nurse (second year) in Nottingham - currently on an adult acutemedical ward #nurchat 8:03 PM Nov 8thgerrybolger Gerry from London #nurchat 8:02 PM Nov 8thAgencyNurse Hi all - Teresa here in Bristol #Nurchat 8:02 PM Nov 8thnursiedeb @NurChat Hello its Debbie from just outside Edinburgh #nurchat 8:02PM Nov 8th NurChat good evening all - lets start with introductions, who is out there thisevening?? #nurchat 8:01 PM Nov 8th
    • NurChat ... and bear in mind the NMC code of conduct and guidelines when tweeting#nurchat 7:59 PM Nov 8th NurChat Please remember as always that your tweets are all your own opinion andnot necessarily those of nurchat... #nurchat 7:58 PM Nov 8th