Maj. Tran Thi Phuong Lan, BN, Chief nurse, Military hosp. 354,

Vietnam People Army

ASSESSMENT OF THE NUTRITING SUPPLY FOR PATIENT‘S WITH THE FIRST LEVEL OF

NURSING CARE

Nutrition has an important role with human health.

1. BACKGROUND

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.

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.

OBJECTIVE

1. Assess the reality of clinical nutrition supply.

2. Propose the appropriated way of clinical nutrition.

Cross-section description combine with prospective and retrospective.

METHOD

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 dayCalculate kcal BMR (Basal Metabolic Rate).

BMR = BEE + AF + TF + IF + WG.

BMR = BEE + AF + TF + IF + WG. Including:

1. BEE (Basal Energy Expenditure)2. AF (Activities Factor)3. TF (Thermal Factor)4. IF (Injury Factor)5. 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 Kcal

500ml Dextrose 5% (25 g Glucose) 100500ml Dextrose 10% (50 g Glucose) 200500ml Dextrose 20% (100g Glucose) 400500ml Dextrose 30% (150g Glucose) 6001000ml Lipovenous 10% 1.080250 ml Lipovenous 10% 2701000ml Alvesin/Chiamin S 370250 ml Alvesin/Chiamin S 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.

General characteristics

3. RESULT AND DISSCUSSION

0

20

40

60

80

100

120

GHD ICU GSD

Age

Gender

76.7%

84.3%

82.0%

23.3%

15.7%

18.0%

GHD

ICU

GSD

Male female

Method of treatment

76.2%17.1%

6.7%

Internal

Surgical

Combination

11.%2.%

35.3%24.6%

2.0% 1.2% 6.8%15.9%

80.9%

Disease Structure

Feeding way

38.9%

9.5%

51.6%

Intravenous Gastrointestine Combination

The reality of nutrition ensuring for patien

The feeding ways

4. CONCLUSION

•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%

General characteristics of object

•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%.

• Energy balance: First day: 27%Second day: 38.1% Third day: 40.1%

The reality of nutrition ensuring for patient

5. RECOMMENDATION

Train the doctors and nurses about clinical nutrition and diet suitable with the disease situation.

Increase the education for patients about the role of nutrition in treatment.

Thank you!My e-mail address: phuonglan354@gmail.com