Nutritional risk factors in patients admitted to an acute hospital

Abstract

was significantly greater for nurses on medical wards (p¼0.02) and those with previous training in NG position checks (p¼0.01). A pH was assigned in all 72 observations of the pH 7 solution with a range of answers given: pH 3.5 (n¼1), pH 5.5 (n¼2), pH 6 (n¼47) and pH >6 (n¼22). Substantial intra-rater reliability was demonstrated (kappa¼0.77) with 84% exact agreement and 94% exact and adjacent agreement. There were no significant factors influencing intra-rater reliability. Overall intra-rater reliability is good, however there are issues with accuracy of pH readings. As bronchial secretions have a minimum pH of 6, exact agreement is required at this level. Underestimation , which occurred in 15% of readings (pH 1.6 and pH 4 solutions), may result in harm. Although this may be addressed by training, which improved accuracy in this study, other strategies may need to be adopted as only half of this cohort had been formally trained despite widespread teaching programmes across the trust. Further consideration should be given to the use of pH meters or lowering the pH threshold for feeding without x-ray, but this poses other issues including radiation exposure, delays in feeding whilst awaiting imaging and difficulties with x-ray interpretation.

Ensuring the future of functional foods

“…One proposed stratagem to help increase nutritional status of the malnourished elderly is the provision of energy and protein dense meals. Fortification or supplementation with high calorie enriched snack products or protein enriched breads and biscuits may help alleviate poor appetite, as older people are also subject to a gradual decline in taste sensitivity and appetite due to physiological changes with age (Beelen et al ., ; McGree et al ., ; Vasse et al ., ; Yamashita et al ., ). However, sensory‐compromised situations, most often associated with taste and smell dysfunctionality are not confined to the elderly.…”