nutrition wound healing10!20!10

8/2/2019 Nutrition Wound Healing10!20!10

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Nutrition Braden Consults Appropriate-Pt on solid food po diet, skipping breakfast, soup forlunch, bites at dinner X 3 days

Not Appropriate-NPO pts-Clear Liquid pts-Pts with good intake at lunch but poor intake at dinner x 1day

-Completing the Braden on evening/night shift after mealsso marking the Nutrition section as 0


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Role of Nutrition Services in

Wound Healing-Assessment

-Intervention

-Monitoring


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Nutrition Assessment- Chart Review

Diagnosis, PMH, wt loss hx, and stage of ulcer orseverity of wound, potential macro- or micronutrientdeficiencies

- Assess Nutrient Needs

- Assess ability to meet those needs per intake analysis

- Review vitamin/mineral supplementation history


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Nutrition Intervention

- Educate patient about high calorie/protein foodsources-Start calorie counts if necessary- Recommend liberalized diet- Offer high calorie/protein supplements- Start vitamin/mineral supplementation


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Nutrition Monitoring-Calculate 3 day average intake per calorie counts and assess ability tomeet needs

-Determine if supplements sent are being consumed

-Ensure adequate fluid needs being met-Maintain glucose control

-Review WOC Nurses notes for wound progress

-Assure Zinc is not exceeding 6 weeks of use

- IF no progress in wounds, despite calorie and protein needs beingmet, consider alternative nutrition interventions


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References1. Scholl et al. J Int Nursing 24(2):124-32. Mar-Apr 2001.2. Mathus-Vliegen. NCP 16:286-91, October 20013. Kohn et al. J Dermatology 27: 258-263, 20014. Russell, L. Br J Nursing 10(6):S42-S49. 2001 (supp)5. Casey G. Nursing Standard 17(23): 55-58. Feb 20036. Breslow et al. J Am Geriat Soc 41:357-62, 1993.7. Ter Riet et al. J Clin Epidemiol 48:1453-60. 1995.

8. Ross. Support Line . 24(4): 3-9, August 2002.9. Malone. NCP 15:253-56, Oct 200010. Wicke et al. Arch Surg 135:1265-1270. Nov 2000.11. Kirk et al. Surgery 1993;114:155-60.12. Barbul et al. Surgery 1990;108:331-33713. Williams et al. Annals of Surgery 236(3): 369-75.14. Heyland. NCP 17:267-72. Oct 2002

15. Suchner et al. Br J Nutr . Jan 2002, 87(supp 1): S121-32.16. Demling et al. Ostomy Wound Mgmt 1998;44(10):58-6817. Mikulin. Ostomy Wound Mgmt Sept 2001, 47(9): 17-2018. Brasseur et al. NCP 15:218-22. Oct 2000.19. Neu J, et al. Current Opinion in Clin Nutr & Metabolic Care 2002; 5(1):69-75.20. Thompson. NCP 20:331-347; June 2005.

nutrition wound healing10!20!10

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