ASSESSMENT OF THE NUTRITING SUPPLY
FOR PATIENT‘S WITH THE FIRST LEVEL OF
NURSING CARE
Maj. Tran Thi Phuong Lan,
BN, Chief nurse, Military hosp. 354,
Vietnam People Army
1. BACKGROUND
Nutrition has an important role with human health.
1. BACKGROUND
Nursing is caring for patients
1. BACKGROUND
Patients usually care
about
doctors
prescribe
medication much or less.
A study in whole country of Bach
Mai hospital in 2011 shows: The
ratio of inpatient malnutrition
reached nearly 50% depended on
age and department. Especially, the
ratio of surgical patient is 78%.
1. BACKGROUND
In fact, at 354 MH, in recent
year,
clinical
nutrition
problem was cared. Hospital
contributed 17 regimes.
OBJECTIVE
1. Assess the reality of clinical nutrition supply.
2. Propose the appropriated way of clinical nutrition.
SUBJECT
252 patients hospitalized are fed by intravenous and/or
gastrointestinal way through sonde in the first 3 days at:
1. Gastrointestinal - hematology dept. (GHD).
2. Intensive care Unit (ICU).
3. General Surgical dept (GSD).
Of 354 MH from Sep 2012 to Sep 2013.
METHOD
Cross-section description combine with
prospective and retrospective.
Chose patients randomly.
Patients fed by intravenous and/or gastrointestinal
way (level 1 nursing care) at least 3 days.
Patients are closely controlled diet .
Build the following up diet table for patient each day
Calculate kcal BMR (Basal Metabolic Rate).
BMR = BEE + AF + TF + IF + WG.
BMR = BEE + AF + TF + IF + WG.
1.
2.
3.
4.
5.
Including:
BEE (Basal Energy Expenditure)
AF (Activities Factor)
TF (Thermal Factor)
IF (Injury Factor)
WG (Weight gain)
Calculate exchanging Nutrition and Kcal:
1 Kcal is considered the essential energy to warm
1 liter water up 10C, at general condition.
+ 100g rice contains 75g starch (1g glucose is 4
kcal).
+ 100g red meat contains 20g protein (1g is 4 kcal)
and 31g lipid (1g is 9 kcal).
THE ENERGY OF FLUID
Kind of fluid
500ml Dextrose 5% (25 g Glucose)
500ml Dextrose 10% (50 g Glucose)
500ml Dextrose 20% (100g Glucose)
500ml Dextrose 30% (150g Glucose)
1000ml Lipovenous 10%
250 ml Lipovenous 10%
1000ml Alvesin/Chiamin S
250 ml Alvesin/Chiamin S
•
•
•
•
Kcal
100
200
400
600
1.080
270
370
92,5
THE RESEARCHING TARGETS
Characterize about age and gender.
Disease structure.
Feeding ways: intravenous and/or gastro-intestine.
The situation of nutrition ensuring with demand: Follow each
day of each department, the feeding way, the weight, assess
the requirement report about diet of nurses.
3. RESULT AND DISSCUSSION
General characteristics
Age
120
100
80
60
40
20
0
GHD
ICU
GSD
Gender
GSD
18.0%
82.0%
ICU
15.7%
GHD
23.3%
76.7%
84.3%
Male
female
Method of treatment
6.7%
17.1%
76.2%
Internal
Surgical
Combination
Disease Structure
80.9%
35.3%
24.6%
11.%
2.%
2.0% 1.2% 6.8%
15.9%
Feeding way
38.9%
51.6%
9.5%
Intravenous
Gastrointestine
Combination
The reality of nutrition ensuring for patien
The feeding ways
4. CONCLUSION
General characteristics of object
•The general characteristics of patient :
Age 61-100: 57.5%
Male: 82.9%
Inpatient: 76.2%
Brain stroke: 35.3%
Other diseases: 80.9%.
• Out of 252 patients that are fed by different ways:
Intravenous: 38.9%,
Gastrointestine: 9.5%
Other: 51.6%
The reality of nutrition ensuring for patient
• Energy balance:
First day: 27%
Second day: 38.1%
Third day: 40.1%
•Energy support related to nutrition way :
Combination: 70%
Intravenous: 15.3%
Gastrointestine: 20.8%
* Energy support related to weight: 33.3% to 55.4%.
•The ratio of patient acording to reports from nurse:
Intravenous: 100%,
Gastrointestine: 25%
Combination: 43.8%.
5. RECOMMENDATION
Increase the education for
patients about the role of
nutrition in treatment.
Train the doctors and nurses
about clinical nutrition and
diet suitable with the disease
situation.
Thank you!
My e-mail address:
phuonglan354@gmail.com