Clinical update
Malnutrition BUBBLES
Essential facts The charitable association BAPEN says malnutrition affects one in four adults admitted to hospital, more than one in three adults admitted to care homes and up to one in five adults admitted to mental health units. In the UK, an estimated three million people are malnourished at any one time.
National Nurses Nutrition Group www.nnng.org.uk BAPEN (formerly the British Association of Parenteral and Enteral Nutrition) www.bapen.org.uk
What’s new According to figures released in August by the Health and Social Care Information Centre, the number of people admitted to English and Welsh hospitals suffering from malnutrition rose by 19 per cent – from 5,469 to 6,520 – in the past year. The UK Faculty of Public health has warned that ill health caused by poor diets is increasing because people can’t afford good quality food. Since 2007, food prices have increased by 12 per cent, while wages have decreased by 7.6 per cent over the same period. Rickets and other signs of poor diet are becoming more apparent.
Signs/symptoms
Malnutrition Task Force www.malnutritiontaskforce. org.uk disease, such as chronic obstructive pulmonary disease, cancer or inflammatory bowel disease. Dementia and other neurological conditions increase the risk, as does debility caused by various factors including immobility, poor support and poverty.
Treatment
The most common symptom of undernutrition is unplanned weight loss, usually between 5 and 10 per cent of body weight within three to six months. Other signs include weak muscles, feeling tired all the time, low mood and an increase in infections or illnesses. Signs of malnutrition in children include failure to grow at the expected rate, irritability, sluggishness or anxiety.
Malnutrition can be identified with a tool, such as the Malnutrition Universal Screening Tool (MUST), which uses five steps to identify adults at risk. In most cases malnutrition is a treatable condition that can be managed using first-line dietary advice to optimise food intake and oral nutritional supplements. Management options include addressing any social issues there may be and ensuring the patient has the ability to shop for and prepare food.
Causes/risk factors
How you can help your patient
Malnutrition is caused by either an inadequate diet or problems absorbing nutrients from food. Those at risk include people with chronic
Screen with an appropriate tool such as MUST. Next, talk to the patient’s GP and consider a dietetic referral for a full assessment.
Expert comment Liz Evans is a nutrition nurse specialist and chair of the National Nurses Nutrition Group
Find out more
‘The issue of malnutrition was highlighted by Florence Nightingale in 1860, when she said: “Thousands of patients are annually starved in the midst of plenty.” How shocking it is that in 2014, these problems are still evident. ‘It’s not always obvious that someone is malnourished. Nurses need to be detectives. But there are triggers that
Malnutrition pathway and screening tool www.malnutritionpathway. co.uk/careplans The UK’s Faculty of Public Health www.fph.org.uk Articles from Nursing Standard Malnutrition and dehydration after stroke (2011) Nursing Standard. 26, 14, 42-46. tinyurl.com/ malafterstroke Preventing malnutrition in prison (2014) Nursing Standard. 28, 20, 50-56. tinyurl.com/ mal-prison
can alert you. For example, if you’re in the community, ask your patient whether they’ve had breakfast. If they say no, then ask when you see them again, to check if there is a pattern. Look at your patients too – are their clothes or jewellery loose? Do they look thin? All of these things may help you to spot the signs of malnourishment.’
18 september :: vol 29 no 4by:: 2014 STANDARD Downloaded24 from RCNi.com ${individualUser.displayName} on Nov 23, 2015. For personal use only. NoNURSING other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
Malnutrition BUBBLES
Essential facts The charitable association BAPEN says malnutrition affects one in four adults admitted to hospital, more than one in three adults admitted to care homes and up to one in five adults admitted to mental health units. In the UK, an estimated three million people are malnourished at any one time.
National Nurses Nutrition Group www.nnng.org.uk BAPEN (formerly the British Association of Parenteral and Enteral Nutrition) www.bapen.org.uk
What’s new According to figures released in August by the Health and Social Care Information Centre, the number of people admitted to English and Welsh hospitals suffering from malnutrition rose by 19 per cent – from 5,469 to 6,520 – in the past year. The UK Faculty of Public health has warned that ill health caused by poor diets is increasing because people can’t afford good quality food. Since 2007, food prices have increased by 12 per cent, while wages have decreased by 7.6 per cent over the same period. Rickets and other signs of poor diet are becoming more apparent.
Signs/symptoms
Malnutrition Task Force www.malnutritiontaskforce. org.uk disease, such as chronic obstructive pulmonary disease, cancer or inflammatory bowel disease. Dementia and other neurological conditions increase the risk, as does debility caused by various factors including immobility, poor support and poverty.
Treatment
The most common symptom of undernutrition is unplanned weight loss, usually between 5 and 10 per cent of body weight within three to six months. Other signs include weak muscles, feeling tired all the time, low mood and an increase in infections or illnesses. Signs of malnutrition in children include failure to grow at the expected rate, irritability, sluggishness or anxiety.
Malnutrition can be identified with a tool, such as the Malnutrition Universal Screening Tool (MUST), which uses five steps to identify adults at risk. In most cases malnutrition is a treatable condition that can be managed using first-line dietary advice to optimise food intake and oral nutritional supplements. Management options include addressing any social issues there may be and ensuring the patient has the ability to shop for and prepare food.
Causes/risk factors
How you can help your patient
Malnutrition is caused by either an inadequate diet or problems absorbing nutrients from food. Those at risk include people with chronic
Screen with an appropriate tool such as MUST. Next, talk to the patient’s GP and consider a dietetic referral for a full assessment.
Expert comment Liz Evans is a nutrition nurse specialist and chair of the National Nurses Nutrition Group
Find out more
‘The issue of malnutrition was highlighted by Florence Nightingale in 1860, when she said: “Thousands of patients are annually starved in the midst of plenty.” How shocking it is that in 2014, these problems are still evident. ‘It’s not always obvious that someone is malnourished. Nurses need to be detectives. But there are triggers that
Malnutrition pathway and screening tool www.malnutritionpathway. co.uk/careplans The UK’s Faculty of Public Health www.fph.org.uk Articles from Nursing Standard Malnutrition and dehydration after stroke (2011) Nursing Standard. 26, 14, 42-46. tinyurl.com/ malafterstroke Preventing malnutrition in prison (2014) Nursing Standard. 28, 20, 50-56. tinyurl.com/ mal-prison
can alert you. For example, if you’re in the community, ask your patient whether they’ve had breakfast. If they say no, then ask when you see them again, to check if there is a pattern. Look at your patients too – are their clothes or jewellery loose? Do they look thin? All of these things may help you to spot the signs of malnourishment.’
18 september :: vol 29 no 4by:: 2014 STANDARD Downloaded24 from RCNi.com ${individualUser.displayName} on Nov 23, 2015. For personal use only. NoNURSING other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
