Dietetics, fortis

FORTIS HOSPITAL, MOHALI

DIETETICS

Group - B

A balanced diet in terms of calories, proteins, fats, carbohydrates, minerals, electrolytes and vitamins is essential for a healthy life. A proper diet provides daily requirement of nutrients to the body, thus enhancing the immunity of the person.

DIETICIANS Are qualified to translate the science of nutrition in

health & disease into practical information about food.

Work as members of multidisciplinary team to look after patients who are under the care of consultants.

Visit IPD patients to check on their health and ensure their diet meets their requirements.

Act as advisors to the doctors on the nutritional standards & specifications for the patient food service to meet the patient’s needs.

DIETETICS AT FORTIS, MOHALI

• The department has a dietetics team consisting of 6 expert Dieticians with the Head of Department, MS. SONIA GANDHI .

• Follows rules as per JCI and NABH.• The Dieticians remain active in patient's care and keep reporting the

nutritional status of the patients as well as act as adviser to the Physicians and the medical team.

• The Dieticians remain in touch with the patients and visit them twice daily.• Normal diet, soft, semi solid, liquid, clear liquid diets and feeds are

provided to the patients - all based on the nature of disease - Diets provided to the admitted patients are complimentary. No food from outside is allowed.

• Dietetics at Fortis works in co-ordination with F&B department.

THE WORK INCLUDESTHERAPEAUTIC DIETS:

Patients receive medical help with their conditions, but some have conditions that can also benefit from special diets. Eating more of certain foods, and avoiding certain things can help to control a patient’s symptoms.

NUTRITIONAL SUPPORT: This means feeding patients who are

unable to feed themselves. Example of this type of patients include patients who had a stroke or a patient who is very weak. This can lead to the speedy recovery of the patient.

OPD PATIENTS

Outdoor patients coming to diet clinic are:

Consultants referrals

Walkins

Follow up

Diet charts are given in a language, easily comprehended by the patients.

Diet consultancy for OPD is attended on the basis of first come first serve basis.

Patients from all categories are accommodated. Special attention is given to vulnerable patients.

All the aspects viz physical, emotional, clinical & social are kept in mind while doing counseling.

Best levels are made to individualize each and every patient diet plan to enhance or improve adherence and compliance to the diet plan provided to the patient.

Services are offered to the patients between 9.00 am to 6.00 pm from Monday to Saturday.

Assessing nutritional status

Preparing diet chart

Checking adherence and response to diet

(follow patients)

Counseling and educating

Communicating in an easy manner

Satisfying all patient queries

Handing over diet charts

SUGGESTIONS FOR OPD Patients can be given a pamphlet, or notes along with diet chart, to read

at home. Thi s will give details of the disease and of its treatment in simple language and will stresse many of the points made at the interview. It will also prepare the way for further instruction.

Food models and pictures should be used to demonstrate the size of portions of food allowed in the diet, and specimens of household measures familiar to the patient in the home are useful when explaining the composition of the diet.

Individual instruction can be supplemented by group discussion in a waiting room of the dietetic clinic. New recipes and variations in the diet can be demonstrated.

IPD PATIENTS

The majority of patients in hospital are greatly interested in food and in their meals. The stay in hospital offers an excellent opportunity for food education. A patient should leave hospital with new ideas on menu planning, on the serving of food and on balancing a diet.

Duty hours for the department members : 7.30 am – 4.00 pm –> morning shift 10.00 pm – 6.30 am -> general shift 11.30 am – 8.00 pm -> evening shift

SERVICES FOR IPD PATIENTS

There are nine meals in a day :Bed teaBreakfastMid morningLunch soupLunchEvening teaDinner soupDinnerHealth beverage

NUTRITIONIST ROUNDS

11.30 am to 2.00 pm - 2 Dieticians

1.30 pm to 3.00 pm – 1 Dietician

2.00pm to 3.15 pm – 1 Dietician It is planned in such a way

that there is always one dietician to attend the calls & patients as well.

Patient & Dietician Interaction

• Interviewing the patient – The object of this interview is to establish good relations between patient and dietician.

• Dieticians avoid encouraging food fads and fancies by over-emphasizing likes and dislikes for particular foods.

• T h e final interview is used to check the diet, to clear u p minor difficulties and, if necessary, to see the patient’s relatives.

CRITICAL IPD PATIENTS

For patients requiring extra care, dieticians recommend following three ways for intake of food :

Oral (with the help of nurses )

Tube feed (nasogastric tube/ rye’s tube )

Parental feed

COMPARIS OF THE DIETARY DEPARTMENT WITH NORMS OF NABH

S.NO OBJECTIVE ELEMENT INTERPRETATION REMARKS

1. Documented policies and procedures guide assessment and reassessment.

Self explanatory. Done in the department.

2. Patients receive food according to their clinical needs.

A dietician should do the assessment of the patient in consultation with clinic and give advice regarding the diet.

Done in the department.

Contd.


3. There is a written order for the diet.

The dietician shall prepare this in a form of diet sheet and patients shall receive food accordingly.


4. Nutritional therapy is planned and provided in a collaborative manner.

The dietician shall ensure that this is planned in consultation with the treating doctor and the patient/patient’s relatives after taking regard the patient’s food habits and likes-dislikes.

Done in department.

Contd.


5. When families provide food, they are educated about the patient’s diet limitations.

The dietician/nurse shall ensure this during planning.


6. Food is prepared, handled, stored and distributed in a safe manner.

The dietary services to be designed in a manner that there is no criss-cross of the traffic. All the activities should fall in a sequence. The organization should ensure that hygienic conditions are followed all throughout.

Done with the help of F&B department.

SUGGESTIONSIt should be a part of International Confederation of

Dietetic Association(ICDA).

The dietician must have a thorough knowledge of current rations and of the available unrationed foods & of their cost.

For the sake of foreign patients foods like boiled spinach, carrots, mashed potatoes etc. can be given.

Menu cards can be sent to the wards from the distribution unit during breakfast.

The department can organize various counseling camps for specific group of patients like Obesity, Hypertension, Diabetes, Migraine, Diet Related to Pregnancy and Lactation etc.

Free diet counseling for poor people should be organized.

On various special occasions like New Year the department can make the staff to take resolutions regarding safe dietary practice.

Create Awareness among poor people through participation in different program, specially for women and children.

PLANNINGProduction and execution is done by maintaining

coordination with F & B department.

After every three months new seasonal cycle menu is prepared to make food suitable for the patient.

DIETICIAN AND IN-PATIENT INTERACTION

Doctor subscribes diet to the patient

IPD SERVICES CONTD. Whenever changes are made by the dieticians,

the concerned doctor and F & B department are informed.

Unscheduled orders are given through call centers.

Addressing of patients query and their issues related to food are solved within 10 min.

Success of instruction in therapeutic dietetics depends primarily upon a spirit of co-operation between patient and relatives on the one side and dietitian on the other. To achieve this a dietitian must have not only patience, perseverance, tact and imagination, but also an abiding interest in all human beings.

Health & Medicine

Dietetics, fortis