Preventing Under-nutrition in Hospitals and Aged Care
- : Melbourne VIC 3001
Because food is intrinsically linked to life it is constantly being talked about. After all, it is part of our health, our wellbeing and our culture. In our current food-obsessed world, much attention is given to over-nutrition as a leading cause for concern. However under-nutrition and malnutrition causing unplanned weight loss is also a serious problem. Under-nutrition harms patients and costs organisations dearly. A conference that informs nurses about evidence-based strategies to prevent under-nutrition and malnutrition causing unplanned weight loss and improve patient outcomes across a range of healthcare settings is timely. Attend this conference and discover:
- Why is poor nutrition so strongly linked to adverse patient outcomes?
- What is the link between under-nutrition, malnutrition and falls, fractured NOF, infections and pressure injuries?
- Who is most at risk of under-nutrition?
- When are nutritional supplements and supports indicated and are they effective?
- How can feeding assistance and other nutritional interventions be implemented in a cost-effective manner?
- Why must certain nursing practices change if nutrition is to be prioritised?
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8:30AM REGISTRATION FOR DAY ONE
Poor Nutrition = Poor Outcomes - A Quality and Safety Concern?
Safety, quality and nutrition have not traditionally been thought of as one. However, this session will explore how failure to provide adequate nutrition in healthcare is strongly linked to poor patient outcomes. Includes:
- How big a problem is under-nutrition and malnutrition in healthcare?
- What Standards exist and are they being complied with?
- How does this relate to accreditation?
- How is quality and safety linked to nutrition?
In Sickness and in Health...What Happens to the Body?
Nutrition is intrinsically linked to our health and our wellbeing. In times of health, the body is very effective at regulating metabolism. But what happens if the body is under-nourished or malnourished? This session explains the physiological changes that occur in a person who is malnourished and will help you understand why its effects are so concerning. Includes:
- How does the body normally meet its energy needs?
- What happens to metabolism when a person is malnourished or under-nourished?
- How can undernutrition and malnutrition cause a cascade of catastrophic effects e.g. infections, fractures and impaired wound healing?
10:30 MORNING TEA
Recognising Malnutrition - Giving it the Attention it Deserves?
Traditionally, the mention of malnutrition may conjure up images of diseases such as scurvy and rickets. However, under-nutrition and malnutrition is a modern problem plaguing our community and found in healthcare settings across the country. This session includes:
- What is the difference between malnutrition, under-nutrition and sarcopenia?
- How are these conditions screened?
- Who is most at risk for developing sarcopenia?
- Which tools are most effective at identifying those at risk of unplanned weight loss e.g. MNA?
Feeding Dependence and Malnutrition - What's the Connection?
The relationship between feeding dependency and malnutrition is important to consider in a range of settings, particularly Residential Aged Care Facilities (RACF). This session explores the issue of feeding dependency and asks whether feeding assistance is the only solution. Includes:
- Are nutritional outcomes poorer in residents who have a feeding dependency?
- What about portion control?
- How can nutrition be improved in patients with a feeding dependency?
- What are the solutions and does this always have to involve extra staffing?
12:30PM LUNCH BREAK
Hungry in Hospital
The introduction of the EQuiP National Standards has shone a new light on nutrition in hospitals. Many patients are already undernourished on admission to hospital, often due to their underlying illness. Alarmingly, the potential for exacerbation during their stay may be significant. This session looks at how malnutrition can manifest in a hospital setting and considers strategies to prevent its occurrence. Includes:
- Everyone's responsibility - How has screening for malnutrition changed?
- How does illness affect the body's energy requirements?
- What causes someone to lose weight during a hospital admission and what can be done to address this?
- What is the impact of malnutrition on healthcare resources?
- How can attitudes towards the provision of food be prioritised by staff?
Dr Jenny Gowan
Should I Give this Tablet? A Look at Medicines and Nutritional Deficiencies
The relationship between medicines and malnutrition is complex. Some medicines may have a negative effect on nutritional status, whilst others may reverse this effect. This session looks at a range of medicines and disease-related factors that affect nutrition and includes:
- Can some medicines be a cause of nutritional deficiencies and when is supplementation required?
- Does unplanned weight loss affect the safety and efficacy of some medicines?
- How do disease-related factors affect a person's ability to take oral medications?
- What guidance is available for giving oral tablets and capsules in people with a swallowing disorder?
3:15 AFTERNOON TEA
Dr Tim Crowe
Delayed Wound Healing and Malnutrition - Partners in Crime?
The burden of delayed wound healing is having a significant impact on healthcare systems across Australia. It is understood that the effects of under-nutrition or malnutrition on wound healing is particularly destructive. This session takes a close look at the evidence that links good nutrition to improved patient and organisational outcomes relating to wound healing. Includes:
- How does under-nutrition relate to delayed wound healing?
- Do people with special diets or food allergies have an additional risk?
- Is nutrition for chronic wounds different to that for acute wounds?
- What is the evidence for nutritional supplements and are they effective?
4:15 CLOSE OF DAY ONE OF PROGRAM
9:00AM COMMENCEMENT OF DAY TWO
Curry, Souvlaki, Sushi, Spaghetti and Chips - Cultural Considerations
Is there anything more off-putting than being served a plate of food that you have never eaten before when your appetite is poor? Good nutrition appreciates a person’s cultural values and practices relating to food. This session considers how integrating culture with nutritional interventions leads to better outcomes. Includes:
- How does cultural naivety in healthcare settings lead to under-nutrition?
- How can you tailor meals to suit everyone’s cultural values?
- Respecting patient preferences - the key to success?
Foods in Tubes - Enteral and Parenteral Nutrition
Nutritional support, in the form of enteral nutrition (EN) or parenteral nutrition (PN) may be indicated for a range of reasons in order to ensure adequate nutrition. This informative session will review the current evidence regarding best-practice enteral nutrition and includes:
- Psychosocial implications of EN and PN
- Should all under- or malnourished patients receive EN? What about PN?
- How should nasogastric tube placement be checked?
- What guidelines exist for the management of PEG tubes in RACF?
- What formulations are suited to which people and what about rates of delivery?
- Troubleshooting for blocked tubes and safety considerations
10:45 MORNING TEA
Addressing Malnutrition in People with Cancer
Patients with cancer are at high risk of malnutrition and the consequences of this are significant from both a patient and an organisational point of view. This session provides a range of evidence-based practical strategies to address malnutrition in people with cancer. Topics to be covered include:
- What causes malnutrition in patients with cancer?
- What are the consequences of malnutrition?
- What strategies have been shown to be effective?
- What is the role of the multidisciplinary team?
Improving Oral Nutrition - Solutions for People Following Stroke
Achieving effective food intake following a stroke is known to improve patient outcomes. This has many benefits including faster rehabilitation and fewer demands on an organisation’s resources. This session looks at nursing and allied health strategies that avoid under-nutrition and malnutrition and its cascading effects on those who have experienced a stroke. Includes:
- How big a problem is under-nutrition and malnutrition post stroke?
- What are the potential causes of under-nutrition in this group of people?
- How do stroke-related factors such as dysphasia impair the intake of nutrients?
- What is the evidence for patient-centred nutritional interventions and what are they?
- How is nutrition incorporated into the ACSQHC Acute Stroke Clinical Care Standard?
12:45PM LUNCH BREAK
Simple Solutions - Practical Nursing Considerations
As nurses are responsible for caring for the whole person, we are in a great position to enact simple but significant changes that can improve the mealtime experience. Key to this is the development of a culture that values nutrition and understands how nutritional outcomes lead to improved patient outcomes. This session looks at a range of practical solutions:
- Mealtime setup - dentures, glasses, utensils and crockery
- Documenting food charts
- Mealtime time-outs - minimising interruptions
- How do you create culture that values nutrition and encourages collaboration between inter-discliplinary teams?
Juli e Orr
Liquid Supplementation and Oral Nutrition in Older People
As we age, the ability to eat safely and effectively may be diminished. In addition, certain diseases, such as dementia, increase caloric requirements. Whilst supplement use must not replace a proper diet, they may be required to enhance food intake. Appropriate selection and use of oral supplements is crucial if cost-effective care is to be administered. Includes:
- When may nutritional supplements be needed?
- How are they chosen?
- What are practical tips for ensuring patients consume them?
- What is the cost of oral supplementation and how do you know they are working?
3:15 AFTERNOON TEA
Would You Eat That? An Interactive Menu Review
Have you ever looked at the plate of food in front of your patients and residents and been utterly disgusted? Would you want to eat what's on their tray? Did you know that there are Standards in place that require regular reviews of menus? This final session will walk you through a review of a hospital and residential aged care menu. You will look at whether the menu is providing nutrition and consider:
- What does this menu look like on a plate?
- Have flavour and texture been optimised for a palpable eating experience?
- What nutrients are sufficient and what are lacking?
- Is this menu worthy of your patient?
4:15 CLOSE OF DAY TWO OF PROGRAM
The Goal Need for Program
Evidence suggests that under-nutrition and malnutrition are strongly linked to poor patient or resident outcomes and even death. National Standards have been introduced to improve the management of nutrition. All nurses have a duty of care to ensure appropriate nutrition is provided. Failing to establish a culture where nutrition is supported and prioritised may prove very costly to both patient and organisation. There are many adverse patient outcomes that can be prevented through proper food and fluid intake. These include: infections; fractures resulting from falls; wound and skin breakdown, and delayed healing. Reducing length of stay, readmission rates and improving patient satisfaction are also tied to good nutrition. Formal CPD that introduces nursing strategies to reduce under-nutrition and malnutrition is needed to reduce the burden of this preventable cause of poor health outcomes.
Purpose of Program
The purpose of this conference is to improve patient, resident and organisational outcomes by enhancing nurses’ knowledge about latest evidence-based strategies to prevent under-nutrition and malnutrition across all health settings.
Your learning outcomes:
Identify how the pathophysiology of under-nutrition and malnutrition may cause detrimental patient outcomes, and initiate preventive action
Combine best evidence with clinical expertise to appropriately select nutritional interventions that are aligned with patient preferences
Promote an organisation-wide culture that prevents unplanned weight loss resulting from malnutrition
Build rapport with interdisciplinary team to deliver holistic healthcare in a collegial manner that is conducive to shared values and patient satisfaction
Dr Sandra Iuliano-Burns (PhD) is a researcher at the University of Melbourne based at Austin Health. Her work focuses on ... Read More
Kathryn is an Accredited Practising Dietitian with over 20 years experience in clinical dietetics and is currently working at Royal ...Read More
Jenny Gowan was the Director of Training and Development at the Pharmaceutical Society of Australia (Victorian Branch) for over 20 ... Read More
Tim Crowe is a nutrition academic within the School of Exercise and Nutrition Sciences, Deakin University, and is also an ... Read More
Maria-Irini Avgoulas is currently employed at La Trobe University in Melbourne. She holds the role of Associate Lecturer in the ... Read More
Kate Fetterplace is a Senior Dietitian at The Royal Melbourne Hospital and specialises in critical care nutrition and nutrition support. ...Read More
Sarah Gilliland is a Senior Clinician – Dietitian for the Head and Neck Services at Peter MacCallum Cancer Centre. ... Read More
Zoe Youl is a Registered Nurse with a background in Critical Care Nursing. She holds a postgraduate qualification in Clinical ... Read More
Julie Orr is a Senior Dietitian at Leading Nutrition, an aged care specialist dietetic consulting organisation. Julie has developed extensive ... Read More
Sharon Er is currently the stroke and neurology unit dietitian for Western Health at Sunshine Hospital. ... Read More