the management and prevention of malnurtition

This essay discusses the importance of management and prevention of malnutrition in the elderly during admission. In the United Kingdom it is estimated that malnutrition affects over 3 million people; of which 1.3 million are over the age of 65 (BAPEN, 2007-11) survey showed that 25 to 34% of people admitted to hospital are at risk of malnutrition (BAPEN, 2018).The British Association for Parental and Enteral Nutrition (2018) states, that malnutrition is a state of nutrition in which a deficiency or excess (or imbalance) of energy, protein and other nutrients causes measurable adverse effects on tissue, body form (body shape, size and composition), function and clinical outcome.According to, the WHO (2019) older people are most susceptible to several diseases as a result of dietary factors, some of which are underlying since infancy; these factors are aggravated by the natural changes that occur with ageing. This essay will explore malnutrition prevention and management, relating to the NMC Code of conduct, the laws and ethical and evidence framework. Analyse role of the nurse in the UK pertaining to evidence base care assessment during the nursing process.I have chosen this topic as I am passionate about safe care. It relates to an incident that occurred during my first placement on elderly ward that involves Mrs Brown (pseudonym) and 84-year-old lady whose weight had not been measured during admission. In (2010) Age UK issued its second report, which suggested that the nutrition and hydration needs of older people in hospital were still unmet (Age UK, 2010). Paragraph 1: Topic sentences • Firstly, the Nursing Midwifery Code of Conduct (2018) provide guidance for nurses to follow in practice whilst making sure the fundamentals of care are delivered effectively; promoting well-being and preventing ill-health. Since the Francis Report (2013) it is appalling that it is now six years on, and we are still having issues in practice regarding patient care. In order to prevent malnutrition, the National Institute for Health and Care Excellence (NICE,2018) recommends that all patients in a care setting should have a regular nutritional screening using a validated tool, the malnutrition universal screening tool is most commonly used. The NMC (2018) recommends that nurses should always act in the best interest of people. Like the NMC the local Trust policy (2018) states, that all adult inpatient should be screened using nutritional screening tools within 24 hours of admission and weekly thereafter if the patient’s condition changes. Nurses have a duty to ensure that all food and fluid intake are appropriate, adequate and suitable to the patient illnesses whilst considering cultural needs Trust (2018). Nutrition and hydration are an essentials part of nursing care nurse’s need to ensure help is provided to those who are not able to feed themselves or drink fluid unaided NMC (2018) .The Care Quality Commission (2011) identifies that needs of patients were not always assessed properly, which meant they did not always get the care they needed for example, specialist diets. Fluid balance and food chart were not kept accurately, so progress was not monitored accordingly. A nurse should be able to identify signs and effects of malnutrition , example, unplanned or unexplained weight loss, feeling tired, lacking energy, difficulty keeping warm, reduced, weaker muscle and tissue mass, decreased mobility and stamina RCN( 2019).An individual body mass may varies the older they become being malnourish may result in general muscle weakness and associate loss of mobility, as well as increase risk of falling, reduces respiratory and cardiac functions, impaired immune system function and delayed wound healing Latham (2010).Therefore nursing staff need to listen to patients, their relatives and carers, understand how illness and medication affect appetite and nutritional needs, assess skin integrity on admission and at regular intervals, understand how ageing affects nutritional needs, work with the patient, families and members of the MDT to address malnutrition, become food aware, meals are just as important as medication provide advice and support to families and carers in relation to diet, make sure mealtimes are protected ,Seeking advice from specialist colleagues is important as soon as needs are identified RCN(2019)