The importance of nutrition support in early intensive interdisciplinary therapy for a brain injury patient

Abstract

, who were identified as at risk of RFS by a doctor, nurse, pharmacist or dietitian were included in the audit. Data was collected on the correct identification of patients, selection of appropriate feeding care plans, energy provision, serum electrolyte monitoring and supplementation and vitamin and trace element prescription. Twenty-one out of 27 patients were identified as at risk of RFS by the dietitian. Fifty-seven per cent (n¼12) of patients at risk of RFS were not identified by ward staff and 22% (n¼6) were incorrectly identified as at risk. Of the 19 patients receiving non-oral nutrition, 63% (n¼12) were commenced on the incorrect feeding care plan. Following assessment by a dietitian or pharmacist, 100% (n¼21) of patients at risk of RFS received the recommended energy provision. Sixty-six per cent (n¼14) of patients did not have the recommended serum electrolyte monitoring. Between 62 and 94% of the 16 patients requiring electrolyte supplementation did not receive it. Vitamin and trace element supplementation was prescribed in 65% of at risk patients but prescription was incorrect or incomplete in 20% of these patients. Compliance with the RFS guidelines is poor which will have an adverse affect on patient safety. Improvements may be achieved by education of doctors and nurses on the identification and management of patients at risk of RFS.