© Royal Berkshire NHS Foundation Trust Nutrition Core Care Plan Version 3 September 2012

Name NHS no.

Date Care plan no:

Patient need / problem Patient has been identified as being at risk of malnutrition during their hospital stay Malnutrition Universal Screening Tool (MUST) score = Before their illness how did the patient usually manage this? Aim / outcome To prevent malnutrition during the patients stay in hospital Date aim / outcome reached

Interventions required to meet aim / outcome (Delete and personalise as appropriate)

Date Nursing interventions Review interval

Sign

If patient MUST score = 1 or more commence on nutrition care bundle

Screening /Assessment and Monitoring Reassessment of MUST is carried out at predetermined intervals

or as a minimum every seven days

Record food intake on Food Chart

Refer to Dietitian within 24 hours of admission if MUST score 3 or more. If MUST score 1or 2 commence nutrition action plan and review on day 3 of admission. Refer to Dietitian if no improvement within three days of interventions.

If patient has had a stroke, Transient Ischaemic Attack or causing concern .e.g. has Parkinson’s, dementia or head injury

• Keep nil by mouth until assessed by a competent health care professional (and ensure medical staff/team aware of this)

• Refer to speech and language therapist for swallowing assessment within next working day of admission (All areas except Elderly Care, Acute Stroke Unit, CDU)

• Elderly Care, Acute Stroke Unit, CDU – Competent nurse to undertake swallowing assessment within 24 hours of admission

Specific dietary requirements Patient requires the following diet/type of food:-

Patient label here

© Royal Berkshire NHS Foundation Trust Nutrition Core Care Plan Version 3 September 2012

Date Nursing interventions Review interval

Sign

Drinking Patient requires the following for drinking (circle as appropriate):-

Normal cup Straw Other (please specify) Beaker (please specify why needed) Ensure drinks are poured and easy for the patient to reach

Record fluid intake on fluid chart Menu choice/choosing food If patient needs assistance at meal times ensure red dot affixed to

menu to indicate that patients need their meal on a ‘red tray’

Patient needs help to choose their food from the menu Photographic menu required for patient to choose their meal/s Prior to Meals/Eating Offer the opportunity to use the toilet

Position upright with head tilted slightly forward

Ensure table is uncluttered and the correct height

Provide opportunity for patient to wash hands before each meal (offer individually wrapped hand wipe/soap and water)

Ensure patient has: - (circle as appropriate) Dentures Glasses Hearing Aid Mouth care

At Mealtimes Ensure no interruptions when patient is eating their meal

The patient needs the following equipment (circle as appropriate) Plate guard Special cutlery Non-slip mat Other (please specify)

Ensure the correct meal is given and it is the correct temperature, quality and quantity.

Patient needs the following assistance:- Cutting up food

Feeding (putting food into mouth) Positioning of table (circle as appropriate) Left Right Assistance to drink (putting the cup/straw/up to their mouth)

In between meals Give nutritional supplements in accordance with Trust Sip Feed

Guidelines

Patient requires a snack at (specify time/s of day)………………….

Patient/family/carer agrees to manage the following aspects of care: