In the early 1970s it was documented that many patients in
hospitals were in poor nutritional status and an even more
appalling observation was that the nutritional status of many
patients deteriorated while they were in hospitals. The causes
were identified so that this problem was resolved. The causes
were many, unfamiliarity with food, side effects of medicines,
nausea, tests, surgery and most important co-ordination and
inattention of the patients. As a consequence of this startling
documentation there is now aggressive nutritional support
available for the patients which is possible only with good
co-ordination between the physician, nurse and clinical
Dietician.
Nutritional care for the ill is complex. It means more than
providing the person with a tray of food 3-times a day. It
includes diagnosis, past medical and dietary history, present
nutritional status, interaction with patient, providing
emotional support and encouragement and then initiating a diet
that is suitable to him as per his disease state.
Interaction
with patients goes a long way in ensuring that the food is
per his therauptic requirement. A fracture patient may have
developed diarrhea hence the diet should change accordingly,or
an evident case may have malleable fracture requiring
blenderised liquid food.
Food
acceptance is better when patients are told why certain food
items are added or deleted from their schedule. Patients who
understand that the diet contributes to the success of the
medical/surgical therapy accept their food restrictions more
willingly. Daily interaction and encouragement to the patient
helps in solving their dietary problems, fears or fads and goes
a long way in improving their Nutritional status of patients and
prevent plate waste.
All
therauptic diets are modification of the normal diet and or
regardless of the diet prescribed. The aim is to supply needed
nutrients in the form the body can handle. Diet is prescribed to
compensate for the dysfunction of the affected body part to meet
specific needs induced by a disease and prevent it from
worsening. It may include:
1. change in consistency.
2. Increase or decrease in energy value.
3. Increase or decrease in the type of food item.
4. Omission of certain foods.
5. Adjustments in ratio and balance of food constituents.
6. Rearrangement of number and frequency of food.
Good
food and menu planning requires imagination and ingenuity in
planning for a variety of food familiar to the patients. The
appearance of food on the tray, it's texture, composition and
right temperature of each food item is very important.
Standardized
recipes, portion control, use of pre-packaged food items
help in controlling plate waste. good store management, ensuring
quality and quantity control with first-in first-out policy help
in minimizing wastage. Identifying good reliable suppliers,
ensures quality at good competitive rates. Accurate assessment
of requirements, good storage facilities for dry and cold items
prevents spoilage and wastage bringing down cost. Inhouse
preparation and baking also helps in curtailing institutional
costs.
Good
purchase policies, good storage and well prepared as per
patients therauptic requirements all collectively goes a long
way in meeting client expectation and dietary requirement while
still maintaining cost control. |
