Importance Of Nutritional Assessment Research Articles

Impact of the nutritional status of children with congenital heart diseases on the early post-operative outcome

BackgroundChildren with congenital heart disease (CHD) frequently become malnourished due to many factors including hypermetabolic state, inadequate caloric intake, malabsorption, and fluid restriction as part of the hemodynamic intervention. The abnormal nutritional status may affect early outcome after pediatric cardiac surgery; we aim to prove the importance of nutritional assessment and patient nutritional preparation before performing pediatric cardiac surgery.ResultsWe conducted a prospective observational cohort study from March 2013 till January 2015. All children from birth until 14 years of age admitted to the pediatric cardiac intensive care unit (PCICU) after cardiac surgery. Nutritional status was assessed preoperatively and prognostic nutritional index (PNI) was calculated. All post-operative outcome parameters, PCICU and hospital length of stay (LOS), ventilation time, the rate of infection, and ICU mortality were recorded. Two hundred fifty-nine children were evaluated. At admission, 179 patients (69%) had intake less than 50% of the recommended daily allowance (RDA) of calories intake. There was a statistically significant relationship between pre-admission RDA and the infection rate (P value 0.018). Severely malnourished patients had significantly longer ICU length of stay (LOS) (P value = 0.049). Similarly, weight and height percentiles have a significant effect on ICU LOS (P value 0.009 and 0.045) respectively. There was a significant relation between PNI ≥ 55 and the ICU LOS (P < 0.05), and ventilation time (P = 0.036). Delay in feeding postoperatively was associated with a higher risk of infection (P = 0.005), and higher mortality (P = 0.03).ConclusionsChildren with CHD were significantly malnourished preoperatively and had further weight loss postoperatively. Preoperative nutritional status and delayed postoperative enteral feeding were associated with a higher infection rate and mortality.

Knowledge and Perceived Quality of Nutrition Care amongst Nurses

Purpose: This study was conducted on nurses from The Sheba Medical Center. The purpose of the study was to investigate nurses’ evaluation of the importance of a nutrition assessment, (b) nurses’ knowledge of nutrition care and (c) nurses’ evaluation of the quality of nutrition care in their department. Design: The study was a quantitative correlational study performed in a university-affiliated, teaching hospital. Methods: Data were collected via a digital questionnaire through head nurses, from 203 nurses and analyzed by frequencies, means and Pearson correlations, independent t-tests, oneway ANOVA and stepwise such as the ability of patients to feed themselves, chew and swallow, multiple linear regression were performed to determine predictors observing whether a patient finishes a meal and offering assistance of nurses’ responses where needed. Findings: Importance of nutritional assessment is positively and significantly correlated to knowledge of nutritional care and quality of nutritional treatment. Female nurses’ knowledge is significantly higher than male. Senior nurses’ knowledge is higher than less senior nurses. Nurses who participated in emergency care training have a significantly higher level of knowledge than nurses who did not participate in this course. Knowledge of nutritional care is not significantly correlated to quality of nutritional treatment. It is important to introduce the role of nurses regarding nutritional care within their departments to doctors and dietitians, as well as involving them in building the intervention course. Conclusions: These findings highlight the importance of checking the quality of nurses’ educational knowledge and improving it through an intervention with specified training surrounding knowledge regarding nutrition, including learning and training.

Estado nutricional de portadores de doença renal crônica em hemodiálise no Sistema Único de Saúde

Malnutrition is a major factor in the evolution of patients with chronic kidney disease (CKD) on hemodialysis (HD). It is associated with increased frequency and the duration of hospitalizations. The scope of this study was to evaluate the nutritional status of patients with CKD on HD in public or private clinics of the Unified Health System in the Federal District. Sociodemographic, biochemical and anthropometric data were obtained from 96 participants, 35.5% of which were from public clinics. Parameters for evaluation of malnutrition in CKD included Body Mass Index (BMI) < 23 kg/m2, reduced arm muscle circumference (AMC) and serum albumin < 3.8 g/dL. From all participants, 14.6% were classified as malnourished (60 ± 12 years; 57% male; 69% private clinics); 33.3% presented adequate nutritional status (55 ± 14 years; 53% male; 57% private clinics); 52.1% had at least one parameter related to malnutrition. BMI below the recommended parameter was the most prevalent variable (42.7%), followed by reduced AMC (41.7%) and serum albumin (33.3%). Based on these results, it may be concluded that at least one positive variable was related to malnutrition in half of the sample, which reinforces the importance of nutritional assessment in the context of the treatment of CKD.

Evaluation of nutritional care of hospitalized children in a tertiary pediatric hospital

Hospitalized children are at risk of malnutrition. The aim of the present study was to evaluate a clinical practice in a tertiary hospital. The nutritional team developed a specific software for screening of malnutrition and risk of malnutrition (Evalnut) that provides also recommendations for the nutritional management of the patient. The data recorded into this program and the tool itself were analyzed and optimizations are highlighted. A retrospective study analyzed the data collected in 2015 during 4931 consecutive hospitalizations (3984 children) at the University Children's Hospital Queen Fabiola. Pivot tables analysis (Excel) of the database of the screening tool was compared with the clinical practice of the dietitians. First data processing excluded records with abnormal or missing values. Impact of nutritional care analysis needs at least 2 evaluations and a positive patient's height trend. In case of height equality, only length of hospital stays less than 2 weeks were kept. This study highlighted inaccurate database records related to imperfections of the computer program, missing or erroneous measures and incomplete encoding. First analysis on 3219 valid hospitalizations showed statistical correlations. Prevalence of malnutrition on admission was 33%, split into 14,5% acute malnutrition, 15% chronic malnutrition and 3,5% mixed malnutrition. Overall, 30,3% of the children were categorized at risk of developing malnutrition during their stay. Positive impact of nutritional management on the resulting nutritional status was demonstrated on the second data selection (352 hospitalizations): WFH median (interquartile range) increased from 96,1% (87,1-106,4) on admission to 96,9% (89,1-106,1) (p<0,01) on discharge. An optimization of the existing software was finally proposed. In our hospital, the dietitians are the most aware on the importance of nutritional assessment and management during hospitalization. Encouraging results are obtained. Inclusion of a nutritional program in the medical file is useful to raise interest amongst caregivers and is particularly valuable for the nutritional follow up of the patients by the nutrition team.

The Importance of Nutritional Assessment and Dietary Counseling in Infants and Young Children with Common Illnesses

The influence of nutrition during early life on physical growth as well as mental development has been thoroughly discussed in the literature. The physical dimensions of the body are greatly influenced by nutrition, particularly during the period of rapid growth in early childhood. Nutritional status affects every pediatric patient's response toillness. Good nutrition is important for achieving normal growth and development. It is indicated that permanent impairment of the central nervous system may result from dietary restriction of imbalance during certain periods of life. If children under 3 years of age show a good nutritional status, it may be assumed that they are well nourished. Several common diseases of children such as iron deficiency, chronic constipation and atopic dermatitis are known food related diseases. Patients with chronic illness and those at risk of malnutrition should have detailed nutritional assessments done. Components of a complete nutritional assessment include a medical history, nutritional history including dietary intake, physical examination, anthropometrics (weight, length or stature, head circumference, midarm circumference, and triceps skinfold thickness), pubertal staging, skeletal maturity staging, and biochemical tests of nutritional status. The use of age, gender, and disease-specific growth charts is essential in assessing nutritional status and monitoring nutrition interventions. Nutrition assessment and dietary counseling is helpful for the cure of disease, and moreover, the prevention of illness. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 33∼44)

Evaluación nutricional de pacientes candidatos a lista de espera de trasplante renopancreático

Simultaneous Kidney Pancreas transplantation is currently the treatment of choice for patients with type 1 diabetes ERD advanced. Scientific studies on the therapeutic benefits of this guarantee acceptance of it as the most suitable for patients. The independence of dialysis and insulin therapy after the transplant represents a significant increase in the quality of life for these patients. In recent years, the importance of nutritional assessment in patients with chronic diseases has increased. There is increasing evidence that malnutrition is associated with an increased risk of morbidity and mortality after surgery. Given the therapeutic choice for these patients and the importance of nutritional status as an independent risk factor for post-transplant complications objective of our work is to describe the nutritional status of patients who are candidates for transplant through objective and subjective parameters of evaluation nutritional. We included 45 patients with type 1 diabetes ERD interned in the Hospital Italiano of Buenos Aires for assessing pre Transplantation during the period June 2007-June 2008. They collected data through a sheet produced by themselves. As parameter anthropometric was calculated body mass index (BMI) by the formula Quetelet (post dialysis Weight (kg) / height 2 (m)) and was ranked as the ranges proposed by the committee of experts from WHO. As a subjective argument took place the Subjective Global Valuation (VGS), which ranked patients in well-nourished (A), mild malnourished (B), moderately malnourished (C) and severely malnourished (D). As biochemical parameters of the data was recorded serum albumin (g/dl) to hospitalizations and this data was obtained from the patient's medical history. The value of the average BMI of the total population was 21.83+/-2.65. According to the sex values were: 21.83+/-2.39 and 21.82+/-2.95 for male and female respectively. The nutritional status according to this indicator was anthropometric Normal in 89% of cases. The 6.66% of the cases submitted 13.33% pre malnutrition and obesity. We found no cases with obesity. Taking into account the albumin 47.45% of patients presented moderate risk of morbidity and mortality. According to GSV 62.22% were classified as well-nourished (Class A). It was the equitable proportion of women and men 33.33% were classified as mild malnourished (Class B). Only 2 cases (8.88%) had moderate malnutrition (Class C). None presented malnutrition Graves (Class C). In our study we can see that patients are candidates for waiting list while normal BMI have presented evidence of nutritional risk when one takes into account the VGS and the average value of albumin.

Nurses ‘must’ control of the nutritional needs of stroke patients

The aim of this observational study was to review nutritional practice within an acute stroke unit (ASU) and compare practice against National Institute for Health and Clinical Excellence (NICE) guidance, National Patient Safety Agency (NPSA) guidelines, and the National Stroke Agenda. 'Observations of Care', a well recognized approach and part of the Royal College of Nursing clinical leadership programme, was undertaken along with a traditional audit to review nutritional care in the ASU. Usually undertaken by persons outside of the team to prevent bias, in this situation the bias was minimized as the auditor was new to the team. Current practice was evaluated and it was important for the team to have ownership of the assessment process. This article also reviews the prevalence of malnutrition in hospitals and the importance of nutritional assessment, the use of screening tools and types of diet that best maintain optimum outcomes. Patients who have experienced a stroke can face a range of problems that influence dietary intake. On admission, 16-31% are already malnourished.

Importance of Nutritional Assessment and Collaboration between Physicians and Registered Dietitians in Detecting Celiac Disease: Two Case Studies

Importance of Nutritional Assessment and Collaboration between Physicians and Registered Dietitians in Detecting Celiac Disease: Two Case Studies

Juvenile rheumatoid arthritis--assessment.

The assessment of overall health status of a child with juvenile rheumatoid arthritis (JRA) is complex and multi-dimensional. The general physical examination is complemented by a rheumatological evaluation that includes determination of articular indices of inflammation and duration of inactivity stiffness. Laboratory assessment plays a critical role in monitoring side effects of pharmacologic management, but is limited in its ability to portray accurately the degree of active inflammation. Newly measureable indicators of inflammatory activity, such as serum cytokine and soluble cytokine receptors will likely become part of routine laboratory assessment in the future. Radiographs remain a useful tool for assessing disease progression, but may be replaced in the future by magnetic resonance imaging. In recent years, rheumatologists have realized that measurement of overall physical and psycho-social functional ability, quality of life, and pain are major descriptors to consider during routine follow-up. They are also critical in the assessment of long-term clinical effectiveness. The importance of nutritional assessment has also been realized. This section seeks to describe some of the methodologic approaches currently used to assess the variables mentioned above, and includes a brief discussion of the evolving instrumentation which attempts to measure variables of a more cognitive or subjective aspect.