NUTRITION SUPPORT

The following page details:

v      High Protein and Energy intake

v      Enteral Nutrition

v      Parenteral Nutrition

High Protein and Energy Intake

Often when feeling unwell weight may be lost because we experience a reduced appetite or find that we are eating less than usual.  However, at these times it is important to maintain the food intake which to help your recovery.  The dietitians are able to give advice to patients in order to help with how best to ensure that patients continue to have a good intake, if they find that they are eating less than usual or loosing weight.  All patients should be screened for their nutritional status using the MUST tool.   Click below for the tool:

MUST PLAN

Ward staff should be able to guide individuals to choose foods that are higher in protein and calories (energy) and also provide information about the nutritional supplement drinks that are available to boost your nutrition intake.  The diet sheets called ‘Eating Well in Hospital: A Guide To Choosing a High Protein, High Calorie Diet from 'The Queen Alexandra Hospital Menu’ is available through the link below:

EATING WELL IN HOSPITAL

If an individual is having difficulties with eating normally at home, please arrange to discuss this with a GP or one of the doctors in the hospital doctor/consultant team.  The GP/Dr can then refer to a dietitian as an out patient. 

The dietitians can provide lots of ideas to help you maintain your intake or encourage weight gain.  These can include food fortification, recipes using foods available at the shops or special products designed to be rich in energy protein vitamins and minerals.

Further information is available in the following leaflets: High Protein High Calorie diet & How to choose a soft diet

High Protein High Calorie Diet

How to Choose a Soft Diet

Enteral Nutrition

Enteral feeding is indicated when oral intake is insufficient or unsafe.  Nutrition support should be tailored to the clinical state.

Naso-gastric feeding is usually used for a short period of time (less than four weeks) or in cases where gastrostomy feeding is inappropriate or contraindicated.

Placement of naso-gastric tubes should follow the PHT guidelines available at:

Insertion and maintenance of fine bore nasogastric feeding tubes in adults

Gastrostomy Feeding is the creation of an artificial tract between the stomach and the abdominal surface and is commonly used for long term enteral support.  The gastrostomy can be placed endoscopically (PEG), surgically, or radiologically (RIG)

Feed provision

In PHT we use the Fresenius range of enteral feeds.  The dietetic department will advise on the amount of feed required and the rate at which it can be used.

Refeeding Syndrome

Is the metabolic and physiological consequence of the depletion, repletion and compartmental shift of potassium, phosphate, magnesium, glucose and vitamin deficiency and fluid restriction.  It occurs when a patient is re-fed after a period of starvation.  This then leads to fluid retention and low levels of potassium, phosphate and magnesium.  Patients who have had a prolonged period of very little or no food for less than five days should be considered as being vulnerable to refeeding syndrome.

Guidelines for the management of refeeding syndrome is available at:

Refeeding Syndrome Guideline

Further information is available on the Clinical Nutrition Website

Parenteral  Nutrition

Is a means of providing nutritional support to an individual where the gastrointestinal tract is not able to absorb nutrients or is inaccessible.

PN should be used under the direction of the nutrition support team including the dietetic department and pharmacy department.

For the guidelines for the management of PN go to: