Use of Points System for Menu Management of Eating Disorders

Abstract

With psychiatric treatment options decreasing, more patients with Anorexia Nervosa are being admitted to the acute care setting for medical management. Menu planning is stressful for both the patient who struggles to maintain control over the calorie content of the meals and the Healthcare Team who strive to ensure nutritional needs are met. In order to reduce the focus on calories and provide an interdisciplinary mechanism to monitor and adjust intake, a points menu system was implemented. All foods on a special menu were assigned a calorie point value using a ratio of 1 point: 60 ± 20 kcals. Good protein sources (5 gms of protein per serving or greater) were identified on the menu by stars. Diet orders were prescribed as “points” and “number of protein sources” based on assessment and treatment goals. Menu choices were monitored to ensure overall calorie and nutrient intake was achieved. Analysis of the menu choices showed the points to be consistently within 20 calories of the patient's original calorie target. Time spent in menu management by the dietitian was reduced by 80% by increasing the ability of patients to make menu choices independently. Defined menu guidelines enhanced trayline and production performance through improved menu readability and standard menu /tally items. This ultimately reduced nursing time spent in menu and food management issues on the unit. This system provided an alternative to meal management for patients admitted to acute care settings when existing meal systems and food options must be used. It also allowed for all team members to work together in providing a consistent and unified approach regarding the nutritional management of the patient.