PatientMealIntakeRecord

WhatdoweknowfromtheNutritionCareinCanadianHospitalsstudy(2010-2013)?• 45%ofpatientsadmittedtoCanadianhospitalsaremalnourished.• Foodintakeof50%orlessextendslengthofhospitalstay,eveninwell-nourished

patients.• 75%ofmalnourishedpatientsweremissedbycurrentdietitianreferralprocesses.

WhatisthePatientMealIntakeRecord?Itisanewformforrecordingpatientmealintakeandfollow-upovera7-dayperiod.

Whydoweneedit?• Tomakeiteasierforstafftomonitorandidentifytrendsinpatientmealintake.• Toincorporateaprocesstoidentifybarrierstopatientfoodintakeandthenecessary

follow-upcorrectiveaction.• IntegratedNutritionPathwayforAcuteCare(INPAC)thatisbeingimplementedon

N3WaspartoftheMore-2-Eatresearchstudyuseschangesinpatientfoodintaketodeterminenutritioncarestrategies/practicespertinenttothepatient.

Whatistheprocessforrecordingpatientmealintake?• At admission andweekly thereafter, aPatientMeal IntakeRecord is posted for all

patientsontotheirroomdoor.• Whenpickingupthepatienttrayaftermealtime,thehealthcareaide(orotherunit

staff):ü Willassessthetrayforpercentage(%)offoodconsumed

(canmakereferencetothe“AssessmentofPatientFoodIntake”posterintheroom)ANDwritethe%onthePatientMealIntakeRecord.

ü Willaskthepatienttwoquestionsifmealintakeis50%orless:Isyourappetitelessthanusual?ANDDoyouhavemealtimechallenges?

Ifpatientanswers“Yes”toeitherquestion,staffwillinquirefurtherwithpatient/familytodeterminecause(s),writecorrespondinglegendnumber(orothercomment)ontheRecordandinitial.

ü Willtakenecessarycorrectiveaction,ifapplicable,toimprove/solvetheproblem,writethecorrespondinglegendnumber(orothercomment)ontheRecordandinitial.

Rev - February, 2017

Arethereanytipsthatwillhelpmecompletethepatientmealintakerecord?

• Whenselectingastandardmeal intake%value(ie0,25,50,75,100%),choosethevalueclosest totheassessed intake. Forexample, ifpatientonly tooka fewbites,record“0”.Ifpatientonlyleftafewbitesonthemealtray,record“100”.Youdonotneedtorecordthepercentagesymbol.

• IfthepatientisNPOforthemeal,write“NPO”intheIntake%columnandnot“0”.• Whenassessing%ofmealconsumed,includeallfoodandfluidsonmealtray

(exceptoralnutritionalsupplements).• Give lessemphasis to the intakeof tea, coffee and soup,as these foodsgenerally

havetheleastnutritionalvalue.• Intakeoforalnutritionalsupplements (ONS)suchasEnsure®orBoost®shouldnot

beincludedinthemealintake%.Ifasupplementisconsumedatmealtime,reportitbywriting,forexample,“ONS–50”.Usethesamestandard%’sasformeals.

• If the patient does not knowwhat “mealtime challenges”would include, you canprovidesomeexamples(aslistedinthelegendontheRecord)tocreatediscussion.

• AClinicalDietitianreferralshouldbesentifpatientintakeis:50%orless,foratleast2mealsperday,for3consecutivedays.

• If patient continues to havemeal intake that is 50% or less and the dietitian hasalreadybeenconsultedandcompletedanassessment,donotsendanewreferral.Instead,under“ActionTaken”column,write“RDfollowing”.

• Refertothespecific“GuidelinesforUse”onpage2oftheRecord.

Whenwillthenewformbeavailableforuse?N3W,participatingintheMore-2-Eatresearchstudy,willbetrialingthenewformforonemonthstartingOctober17,2016.

CanIprovidefeedbackonthenewform/process?WhatifIhavequestions?Yes.Afterthefirst2weeks,therewillbeareviewcompletedandstaffinputwillberequested.Ifyouhaveanyquestionsduringthetrial,contactadietitian(ChelsaMarcell,StephanieBarnes,orDonnaButterworth),theN3WclinicalmanagerorFamilyMedicineprogrameducator.