GEP Medicine in Society Handbook 2019/20

5. Secondary Care Themed Days

5.10. Day 11 Theme: Nutrition and Feeding in the In-patient setting

Introduction – Sick patients are often catabolic and require increased nutritional intake and support at a time when they are often unable to feed themselves or simply do not feel like eating. Neurological and gastrointestinal conditions may also affect a patient’s ability to swallow normally or safely (termed dysphagia). During the past thirty years supplemental feeding techniques and support have improved, allowing patients to be fed.

Challenge Box – What are the mechanisms that allow a person to swallow normally? What are the common processes that affect these mechanisms? How would you ensure a patient in hospital receives adequate nutrition?

 

  Learning Issues

  • What are the reasons why patients may not receive adequate nutrition in hospital? What simple things could you do to improve their nutritional intake?
    • How much does the NHS spend on food for each patient per day?
    • Which nutritional supplements are commonly used on the wards? Comment on their nutritional contents.
    • What are NG, PEG and PEJ and TPN feeding? What are their risks and benefits?
    • What disorders commonly stop patients eating?
    • Which members of the MDT are essential when assessing a patient’s swallow?
    • Why may pulse oximetry be used when assessing a patient’s swallow?

 

Learning tasks – set by SALT

 

  • Compare and contrast your own dietary intake for your day at Newham with that of a typical inpatient.
  • List three types of patient who may require ‘special’ diets and the essential elements of those diets.
  • List the stages involved in assessing a patient's swallow.
  • List at least 5 clinical signs of aspiration (immediate and/or delayed)
  • List the risks of PEG feeding. What are the common methods used to try and avoid them and treat them once they have occurred?