|
SUMMARY OF RECOMMENDATIONS
The EPUAP recommends that as a minimum, assessment of nutritional status
should include regular weighing of patients, skin assessment, documentation
of food and fluid intake. Additional procedures including anthropometric
measurements and laboratory tests may also be performed although these
may best be viewed as more advanced assessment techniques. Nutritional
intervention should focus upon improving the individual’s intake
of food and fluids – through consideration of the quality of what
is offered along with removing physical or social barriers to its consumption.
Nutritional supplementation may be considered where it is not possible
to enhance the individual’s own consumption of food and fluids.
References used in the development of this
guideline
American Society for Parenteral and Enteral Nutrition Board of Directors.
Definition of terms used in ASPEN guidelines and standards. JPEN 1995;
19: 1–2.
Benati G, Delvecchio S, Cilla D, and Pedone V. Impact on pressure ulcer
healing of an arginine enriched nutritional solution in patients with
severe cognitive impairment. Arch Gerontol Geriatr, 2001, 33 Suppl 1,
43–47.
Bourdel-Marchasson I, Barateau M, Rondeau V, Dequae-Merchadou L, Salles-Montaudon
N, Emeriau JP, Manciet G, and Dartigues JF. A multicenter trial of the
effects of oral nutritional supplementation in critically ill older inpatients.
GAGE Group. Groupe Aquitain Geriatrique d’Evaluation. Nutrition,
2000, 16(1), 1–5.
Breslow RA, Hallfrisch J, Guy DG, Crawley B, and Goldberg AP. The importance
of dietary protein in healing pressure ulcers. J Am Geriatr Soc, 1993,
41(4), 357–362.
Chernoff RS, Milton KY, and Lipschitz DA. The effect of a very high protein
liquid formula on decubitus ulcers healing in longterm tubefed institutionalised
patients. J Am Diet Assoc,1990, 90, A–130.
Delmi M, Rapin CH, Bengoa JM, Delmas PD, Vasey H, and Bonjour JP. Dietary
supplementation in elderly patients with fractured neck of the femur.
Lancet, 1990, 335(8696), 1013–1016.
Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson
RA, and Jeejeebhoy KN. What is subjective global assessment of nutritional
status? J. Parenter. Enteral Nutr., 1987, 11: 8–13
Gray-Donald K, Payette H, and Boutier V. Randomized clinical trial of
nutritional supplementation shows little effect on nutritional status
among free-living frail elderly. J Nutr 1995; 125(12): 2965–71.
Green CJ. Existence, causes and consequences of disease related malnutrition
in the hospital and the community, and clinical and financial benefits
of nutritional intervention. Clinical Nutrition 1999; 18(Supp 2): 3–28.
Keele AM, Bray MJ, Emery PW et al. Two phase randomized controlled clinical
trial of postoperative oral dietary supplements in surgical patients.
Gut 1997; 40: 393–399.
Langer G, Schloemer G, Knerr A, Kuss O, and Behrens J. Nutritional interventions
for preventing and treating pressure ulcers (Cochrane Review). In: The
Cochrane Library, Issue 4, 2003. Chichester, UK: John Wiley & Sons,
Ltd.
Lipschitz DA, Mitchell CO, Steele RW et al. Nutritional evaluation and
supplementation of elderly subjects participating in a ‘meals on
wheels’ programme. JPEN 1985; 9: 343–347.
Mathus-Vliegen EMH. Nutritional status, Nutrition and Pressure Ulcers.
Nutrition in Clinical Practice 2001; 16: 286–291.
Norris JR and Reynolds RE. The effect of oral zinc sulfate therapy on
decubitus ulcers. J Am Geriatr Soc, 1971, 19,
793–797.
Robinson G, Goldstein M, and Levine GM. Impact of nutritional status on
DRG length stay. JPEN 1987; 11: 49–52.
Taylor TV, Rimmer S, Day B, Butcher J, and Dymock IW. Ascorbic acid supplementation
in the treatment of pressuresores. Lancet, 1974, 2(7880), 544–546.
ter Riet G, Kessels AG, and Knipschild PG. Randomized clinical trial of
ascorbic acid in the treatment of pressure ulcers. J Clin Epidemiol, 1995,
48(12), 1453–1460.
The EPUAP would suggest that a sound starting point for
further exploration of the links between nutrition and pressure ulcers
would be the publication:
Mathus-Vliegen EMH. Nutritional status, Nutrition and Pressure Ulcers.
Nutrition in Clinical Practice 2001; 16: 286–291.
Text prepared by Michael Clark on behalf of the Guideline
Group, 16 November 2003.
Published in 2003.
|
