With one third of all patients coming into hospital at risk of malnutrition (Nursing Times 2011) it is more important than ever that we ensure nutrition of our patients remains high on the agenda. As Nurses we are all aware that “Good nutrition, hydration and enjoyable mealtimes can dramatically improve older peoples health and well being” (McWilliams 2008) and how important it is to consider nutrition when thinking of other aspects of care such as wound healing, medication, and susceptibility to infection. So with this in mind how can we identify these “at risk” patients at the point of admission? But the care does not stop with assessing and identifying the patients who are at risk; what can we do practically to promote good nutrition especially to those who are most vulnerable? From ensuring that those who need assistance get assistance to promoting a good eating environment, ensuring that patients have the right equipment with which to eat and promoting the right calorie intake – how can nurses ensure that their patients are getting the right nutritional care? Thanks goes to @KevinHamPlymUni for this discussion suggestion. Click the picture to download a printable PDF for notice boards Some suggested reading material is linked below – please feel free to add to this if you find something that others will find useful. Third of hospital inpatients at risk of malnutrition (2011) Nursing Times Assessing the benefits of a malnutrition screening tool McWilliams (2008) Nursing Times Malnutrition Universal Screening Tool – BAPEN Innovations: a nurse led, multi professional approach to nutrition (2008) Nursing Times Nutrition Now (2007) Nursing Standard Nutrition older people (2011) Nursing Standard

1. AgencyNurse @MacMoomin hope your washing machine is ok !! #Nurchat 9:08 PM
Nov 8th
nursiedeb RT @AgencyNurse: Thank you all, great conversation :-)) #Nurchat 9:08
PM Nov 8th
AgencyNurse @kathjlo Sorry to hear that ! You can catch up by reading the
transcript later - will let you know when it's up ! #Nurchat 9:07 PM Nov 8th
AgencyNurse Thank you all, great conversation :-)) #Nurchat 9:06 PM Nov 8th
nursemaiden @AgencyNurse #NurChat night all! Home duties call! Thanks for great
session again! 9:06 PM Nov 8th
McCandlish Really interesting converstation :) thank you #Nurchat 9:04 PM Nov 8th
kathjlo #Nurchat sorry you lost me halfway through lol had wash dye from my hair!
Got told today i look 43 ( I'm 38) :( 9:03 PM Nov 8th
bigdfaekillie I think the foremost thing should be informed choice as well as dignity
and respect #nurchat 9:03 PM Nov 8th
AgencyNurse RT @nursemaiden: #NurChat It doesnt all have to be down to money,
its culture again, values etc? #Nurchat 9:03 PM Nov 8th
AgencyNurse @gerrybolger You are right - however investment in the current
economic climate is not forthcoming !! #Nurchat 9:02 PM Nov 8th
NurChat please enjoy the chat for as long as you like this evening, another great
NurChat thanks to you all :) #nurchat 9:02 PM Nov 8th

2. NurChat transcript will be up later, and download for next chat available soon.
#nurchat 9:01 PM Nov 8th
gerrybolger RT @nursemaiden: #NurChat It doesn't all have to be down to money,
its culture again, values etc? 9:01 PM Nov 8th
AgencyNurse @KevinHamPlymUni Thanks for suggesting a great subject #Nurchat
9:01 PM Nov 8th
nursemaiden #NurChat It doesn't all have to be down to money, its culture again,
values etc? 9:01 PM Nov 8th
gerrybolger @AgencyNurse Its about investing in quality not an overhead... good
nutrition & hydration pays for itself tenfold #Nurchat 9:01 PM Nov 8th
MacMoomin #nurchat cheers @McCandlish good chat! 9:01 PM Nov 8th
RT @NurChat: thank you all for tonights input, espcially @KevinHamPlymUni for
the topic and @newcrosshealth for supporting NurChat #Nurchat 9:01 PM Nov 8th
Gaggyy @NurChat Gotta go! Lovely chatting to everyone tonight about #Nutrition!
#NurChat 9:00 PM Nov 8th
AgencyNurse @nursemaiden I so agree with you there !! It's the only way to nurse
#Nurchat 9:00 PM Nov 8th
KevinHamPlymUni #Nurchat thanks everyone for a great chat bye 9:00 PM Nov 8th
NurChat thank you all for tonights input, espcially @KevinHamPlymUni for the
topic and @newcrosshealth for supporting NurChat #nurchat 9:00 PM Nov 8th

3. MacMoomin RT @nursemaiden: #NurChat I now vow never to allow any of my
patients experience the same thing. Dignity and respect, treat how u wish be treated
urself 9:00 PM Nov 8th
JigsawHealth RT @gerrybolger IMHO training is only part of the problem, its about
resources & values - adequate nutrition is key for recovery #nurchat 9:00 PM Nov 8th
nursemaiden #NurChat I now vow never to allow any of my patients experience the
same thing. Dignity and respect, treat how u wish be treated urself 8:59 PM Nov 8th
AgencyNurse @nursemaiden Yes it is , but how do we resolve this?? It all comes
down to cost - training, staffing, better food £££££ !! #Nurchat 8:59 PM Nov 8th
NurChat almost closing time this evening, next chat 22nd Nov "effect of the
environment on pt and health" #nurchat 8:59 PM Nov 8th
nursemaiden #NurChat I witnessed my elderly father being cared for in acute
hospital. It was an eye opener being on the other side of fence! 8:57 PM Nov 8th
AgencyNurse @KevinHamPlymUni Yes we are back to fundamental care - so
important to promote recovery and prevent complications #Nurchat 8:56 PM Nov 8th
NotFromBolton @AgencyNurse Ahhh buts that's expensive #Nurchat 8:56 PM Nov
8th
NurChat RT @McCandlish: I have been fed, had my teeth brushed, been hoisted. and
think you need this to understand how to help pts. #nurchat 8:55 PM Nov 8th
KevinHamPlymUni #Nurchat we try to instill the importance of the fundamentals of
nursing care before getting too involved with other roles 8:54 PM Nov 8th
McCandlish I have been fed, had my teeth brushed, been hoisted. and think you need
this to understand how to help pts. #Nurchat 8:54 PM Nov 8th

4. nursemaiden #NurChat 8:54 PM Nov 8th
McCandlish RT @AgencyNurse: @NotFromBolton Yes if we were all robots !!! But
we are human beings after all !! #Nurchat 8:54 PM Nov 8th
AgencyNurse @bigdfaekillie Thats not good - when did we get too short staffed to
not ensure ppl are adequately fed and hydrated ? #Nurchat 8:54 PM Nov 8th
AgencyNurse @NotFromBolton Yes if we were all robots !!! But we are human
beings after all !! #Nurchat 8:53 PM Nov 8th
bigdfaekillie @AgencyNurse yes, I think its down to staffing levels though #nurchat
8:52 PM Nov 8th
UKDietitian Thanks to all, sorry I have to go now, brilliant to hear all your
comments. #nurchat 8:52 PM Nov 8th
NotFromBolton #Nurchat NG tubes and a liquidator? Reduced cost and improved
performance in one go #winning 8:51 PM Nov 8th
AgencyNurse @bigdfaekillie On the wards ? #Nurchat 8:51 PM Nov 8th
bigdfaekillie @KevinHamPlymUni as a second year student, I agree with you about
the theory side, unfortunately we dont see this in practice #nurchat 8:51 PM Nov 8th
UKDietitian @AgencyNurse Brilliant to hear that! I should include that in my
training, I make Drs drink Fortisips after all! #nurchat 8:50 PM Nov 8th
KevinHamPlymUni “@gerrybolger: @KevinHamPlymUni Can they put it into
practice when they go into placement? #Nurchat” > I'd be amazed if they couldn't
8:50 PM Nov 8th

5. gerrybolger IMHO training is only part of the problem, its about resources (people &
food) & values - adequate nutrition is key for recovery #nurchat 8:49 PM Nov 8th
Gaggyy @AgencyNurse @UKDietitian Same here, I had to be fed and feed a kitchen
staff, as well as being hoisted! Was great #Nurchat 8:49 PM Nov 8th
AgencyNurse @McCandlish your placement sounds like they have it sussed !!
#Nurchat 8:49 PM Nov 8th
McCandlish we have a nutritional link nurse who has developed a good resource for
the whole ward, and attends regular extra training herself #Nurchat 8:48 PM Nov 8th
gerrybolger @KevinHamPlymUni Can they put it into practice when they go into
placement? #Nurchat 8:48 PM Nov 8th
nursemaiden @AgencyNurse #NurChat why do we always seem to go around in
circles we have talked about this for years haven't we! 8:48 PM Nov 8th
AgencyNurse @UKDietitian I had some fabulous training that included being fed !!
Interesting and recommended experience #Nurchat 8:47 PM Nov 8th
KevinHamPlymUni #Nurchat we educate our students in theory and through
simulation in the skills lab regarding nutrition 8:47 PM Nov 8th
gerrybolger @AgencyNurse I agree QIPP is about prevention, not reaction &
investing more in nutrition & hydration would also reduce LOS too #Nurchat 8:47
PM Nov 8th
nursiedeb @AgencyNurse You have hit the nail on the head there. #nurchat 8:47 PM
Nov 8th
NurChat RT @AgencyNurse: @nursiedeb @gerrybolger mad that the NHS spend so
little on food but lots monitoring malnutrition!! #nurchat 8:47 PM Nov 8th

6. NurChat RT @UKDietitian:Most definitely! Our Trusts nutritional ward training
runs on a rolling basis and is our best tool to help #nurchat 8:46 PM Nov 8th
AgencyNurse @nursiedeb @gerrybolger mad that the NHS spend so little on food
but lots monitoring malnutrition!! #Nurchat 8:46 PM Nov 8th
gerrybolger RT @NotFromBolton: #nurchat People admitted to hospital are usually
fairly I'll. This means they are in a maln… (cont) http://t.co/tlA5C2gX 8:46 PM Nov
8th
mikkywatt RT @McCandlish: I also dislike it when pts are able to feed themselves,
slowly, but staff feed them to speed things ups. #nurchat 8:46 PM Nov 8th
UKDietitian @NurChat Most definitely! Our Trusts nutritional ward training runs on
a rolling basis and is our best tool to help #nurchat 8:46 PM Nov 8th
NurChat RT @NotFromBolton: #nurchat People admitted to hospital are usually
fairly I'll. This means they are in a malnourished state already. Feeding up is the game
;) 8:45 PM Nov 8th
Gaggyy @NurChat BASICALLY! imo, there's not enough staff, there's not enough
funding, and there's not enough training. #Nurchat 8:45 PM Nov 8th
gerrybolger @UKDietitian I agree facilities are necessary & they did have a variable
seasonal locally sourced menu with dietican input #nurchat 8:45 PM Nov 8th
NotFromBolton #nurchat People admitted to hospital are usually fairly I'll. This
means they are in a malnourished state already. Feeding up is the game ;) 8:44 PM
Nov 8th
McCandlish I also dislike it when pts are able to feed themselves, slowly, but staff
feed them to speed things ups. #Nurchat 8:44 PM Nov 8th
NurChat so are we saying that more training is needed ? #nurchat 8:44 PM Nov 8th

7. rc4gehr Giving the correct sized portions for pt, have seen overloaded plates when
small have been requested. Can be off putting. #nurchat 8:44 PM Nov 8th
UKDietitian @gerrybolger And this works best when you have a seasonal menu to
make the most of local foods at their best price #nurchat 8:44 PM Nov 8th
nursiedeb RT @gerrybolger: & remember food & hydration is linked to many other
preventable issues, ulcers, VTEs, falls and impacts of recovery - #nurchat 8:44 PM
Nov 8th
mikkywatt @nursemaiden Definitely sitting, how off putting must it be to have
someone stand over you shoving food in your mouth?! #nurchat 8:43 PM Nov 8th
KevinHamPlymUni #Nurchat touché I worked in private sector and the quality of
food is amazing 8:43 PM Nov 8th
AgencyNurse RT @gerrybolger: & remember food & hydration is linked to many
other preventable issues, ulcers, VTEs, falls & impacts of recovery #Nurchat 8:43 PM
Nov 8th
NurChat RT @gerrybolger: & remember food & hydration is linked to many other
preventable issues, ulcers, VTEs, falls and impacts of recovery - #nurchat 8:42 PM
Nov 8th
McCandlish #Nurchat oral hygiene is often forgotten, however we do have lots of
toothbrushes and toothpaste, and I try and make sure I remind my bay. 8:42 PM Nov
8th
UKDietitian @gerryblogger Very true, but if you don't have an onsite kitchen to cook
it it still has to be reheated to be served! #nurchat 8:41 PM Nov 8th
nursemaiden @AgencyNurse #NurChat I now work in independent sector quality of
food excellent and hostesses to collect order and serve etc! 8:41 PM Nov 8th

8. KevinHamPlymUni #Nurchat perhaps oral hygiene could be a future topic? 8:41 PM
Nov 8th
AgencyNurse @gerrybolger Yes SIT DOWN !! I agree !! #Nurchat 8:41 PM Nov 8th
gerrybolger & remember food & hydration is linked to many other preventable
issues, ulcers, VTEs, falls and impacts of recovery - #nurchat 8:41 PM Nov 8th
nursiedeb @AgencyNurse I agree! Oral hygiene is so important! I better not get on
my high horse. I may fall off! #nurchat 8:40 PM Nov 8th
mikkywatt Hear hear! RT @Gaggyy: @kathjlo @AgencyNurse I agree oral hygiene
is always forgotten about!! SO ANNOYING! #nurchat 8:40 PM Nov 8th
gerrybolger RT @nursemaiden: @gerrybolger#Nurchat its both quality of food and
staff to sit down and supervise feeding! Sitting and not standing!! 8:40 PM Nov 8th
NotFromBolton @registerpatient Then it's not a big enough problem then. #Nurchat
8:40 PM Nov 8th
gerrybolger On BBC Countryfile in the Midlands showed you can feed pts with
locally sourced highly nutritional food cheaper than chilled food #nurchat 8:40 PM
Nov 8th
KevinHamPlymUni RT @nursemaiden: @gerrybolger#Nurchat its both quality of
food and staff to sit down and supervise feeding! Sitting and not standing!! 8:39 PM
Nov 8th
AgencyNurse RT @Gaggyy: @kathjlo @AgencyNurse I agree oral hygiene is
always forgotten about!! SO ANNOYING! #Nurchat 8:39 PM Nov 8th
AgencyNurse RT @gerrybolger: @nursemaiden but the cost to the NHS with
malnourishment a poor food budget gas to be false economy?? #Nurchat 8:39 PM
Nov 8th

9. mikkywatt @gerrybolger @agencynurse @nursemaiden Remember reading it was
less than the budget for prisoners, not enough for good healthy food #nurchat 8:39
PM Nov 8th
nursemaiden @gerrybolger#Nurchat its both quality of food and staff to sit down and
supervise feeding! Sitting and not standing!! 8:39 PM Nov 8th
AgencyNurse @bigdfaekillie add #nurchat to your tweets, then we can see you in the
chat, suggest www.tweetchat.com to follow others tweets :) 8:39 PM Nov 8th
Gaggyy @kathjlo @AgencyNurse I agree oral hygiene is always forgotten about!!
SO ANNOYING! #nurchat 8:39 PM Nov 8th
UKDietitian @kathjlo In the good old days we had onsite kitchens cooking fresh
food & ward kitchens for cooking snacks on demand. Sadly no more #nurchat 8:38
PM Nov 8th
gerrybolger RT @KevinHamPlymUni: #Nurchat research in 1970s show similar
percentages as today for malnourishment in hospitals 8:38 PM Nov 8th
gerrybolger @AgencyNurse I believe so, maybe if we have any dietican's they could
advise? #Nurchat 8:37 PM Nov 8th
nursemaiden @AgencyNurse#Nurchat personally I would like to see wards have
their own volunteers, there are many people willing to do this 8:37 PM Nov 8th
AgencyNurse RT @KevinHamPlymUni: #Nurchat research in 1970s show similar
percentages as today for malnourishment in hospitals #Nurchat 8:37 PM Nov 8th
kathjlo @AgencyNurse i think thats it we didnt have so much other stuff to do
#nurchat 8:37 PM Nov 8th
AgencyNurse @gerrybolger really, as little as that ? #Nurchat 8:37 PM Nov 8th

10. KevinHamPlymUni #Nurchat research in 1970s show similar percentages as today
for malnourishment in hospitals 8:37 PM Nov 8th
rc4gehr #nurchat hi I'm Claire (Midlands) was late so have been lurking #nurchat
8:37 PM Nov 8th
AgencyNurse @kathjlo surely there have always been both underweight and
overweight pts, but did we use to have time to care?? #Nurchat 8:36 PM Nov 8th
robertjgardner RT @nursemaiden: @AgencyNurse#Nurchat we used to have lots of
volunteers in our A&E department, they were brilliant at making tea, getting
sandwiches etc 8:36 PM Nov 8th
gerrybolger @nursemaiden Is the issue how much budget set to feed each patient in
24 hours, isn't it something like less than £4 a day? #Nurchat 8:36 PM Nov 8th
kathjlo @AgencyNurse ooh dont get me started on oral hygiene lol #nurchat 8:36 PM
Nov 8th
nursiedeb RT @nursemaiden: @AgencyNurse#Nurchat we used to have lots of
volunteers in our A&E department, they were brilliant at making tea, getting
sandwiches etc 8:35 PM Nov 8th
kathjlo did we have these issues with nutrition in the good old days or is this
something new lol? #nurchat 8:35 PM Nov 8th
gerrybolger @mikkywatt For the record, it's an approached used in one US hospital,
it works for them for all harm risks #nurchat 8:34 PM Nov 8th
AgencyNurse @nursemaiden that's excellent and just what is needed surely !
#Nurchat 8:34 PM Nov 8th

11. NurChat RT @nursemaiden: @AgencyNurse#Nurchat we used to have lots of
volunteers in our A&E department, they were brilliant at making tea, getting
sandwiches etc 8:34 PM Nov 8th
AgencyNurse What about oral hygiene - I often see this go unnoticed as very
important !! Is this another time thing? #Nurchat 8:33 PM Nov 8th
mikkywatt @gerrybolger Coloured nightwear? Think I would have issues with that,
not sure it is very dignified. #nurchat 8:33 PM Nov 8th
NotFromBolton @registerpatient Exactly, there's your problem. Now what's the
solution? #nurchat 8:33 PM Nov 8th
nursemaiden @AgencyNurse#Nurchat we used to have lots of volunteers in our A&E
department, they were brilliant at making tea, getting sandwiches etc 8:33 PM Nov
8th
NurChat RT @nursiedeb: @NurChat One again I am astounded by the depth of
knowledge of nurchatters out there. What a way to learn! #nurchat 8:31 PM Nov 8th
gerrybolger @agenc@AgencyNurse i agree its their approach hich works from them
- similar to redtrays & jugs here #Nurchat 8:31 PM Nov 8th
nursiedeb @NurChat One again I am astounded by the depth of knowledge of
nurchatters out there. What a way to learn! #nurchat 8:31 PM Nov 8th
AgencyNurse RT @nursemaiden: @AgencyNurse I mentioned that to a hospital and
was told volunteers werent allowed to incase a patient choked??? #Nurchat 8:31 PM
Nov 8th
kathjlo @nursemaiden @AgencyNurse yes i ve heard that too but our volunteers do
help and are very good #nurchat 8:31 PM Nov 8th
CaraSloss #nurchat MUST def only a small part of the big picture, overwt & underwt
equally at risk, nutrition assistants massive help on wards! 8:30 PM Nov 8th

12. NotFromBolton #Nurchat Give people crap and then wonder why they are not
eating? It doesn't add up. Would you eat it? 8:30 PM Nov 8th
AgencyNurse @gerrybolger Sounds like a good idea , but not sure I would want to be
the pt in different coloured nightwear !! #Nurchat 8:30 PM Nov 8th
UKDietitian @AgencyNurse We too have been told volunteers can only assist by
opening packets/giving encouragement, not feeding! #nurchat 8:30 PM Nov 8th
NurChat should we be sending the transcript to @jamieoliver tomorrow
@notfrombolton? #nurchat 8:30 PM Nov 8th
kathjlo @McCandlish as long as they have food hygiene certificates then thats fine
#nurchat 8:30 PM Nov 8th
nursemaiden @AgencyNurse#Nurchat I mentioned that to a hospital and was told
volunteers weren't allowed to incase a patient choked??? 8:29 PM Nov 8th
gerrybolger In US (Parkland Hospital Texan) use coloured nightwear to identify
vulnerable patients #nurchat 8:29 PM Nov 8th
McCandlish Would volunteers be allowed? As visitors are not allowed to assist at
meals as far as I am aware. #nurchat 8:28 PM Nov 8th
AgencyNurse RT @gerrybolger: @AgencyNurse The link to the proposed outcome
measurement indicator is here http://t.co/EaNd1iKz#Nurchat 8:28 PM Nov 8th
UKDietitian @AgencyNurse: We've found adapted cutlery, plates & mugs have
made huge difference to some of our patients. #nurchat 8:28 PM Nov 8th
Gaggyy @NotFromBolton I quite like hospital food :P #Nurchat 8:28 PM Nov 8th

13. AgencyNurse @gerrybolger Great thank you :-)) #Nurchat 8:28 PM Nov 8th
kathjlo @AgencyNurse couldnt agree more but i think because they are overweight
they are treated differently not classed as high risk #nurchat 8:28 PM Nov 8th
McCandlish My current ward is very good at protecting meal times, doctors were
running late on ward round one day but thats all ive seen #nurchat 8:28 PM Nov 8th
gerrybolger @AgencyNurse The link to the proposed outcome measurement
indicator is here bit.ly/rPiZTt #Nurchat 8:27 PM Nov 8th
NotFromBolton #Nurchat But when is some one actually going to sort out the fact
that hospital food is a massive contributory factor. Its awful #noexcuse 8:27 PM Nov
8th
AgencyNurse @nursemaiden What about mealtime volunteers ?? Would this help?
#Nurchat 8:27 PM Nov 8th
Gaggyy RT @KevinHamPlymUni: #Nurchat also encouraging visitors to visit at
mealtimes to help or encourage patients to eat 8:27 PM Nov 8th
Gaggyy @mikkywatt @KevinHamPlymUni I have views for and actually against
protected meal times. #Nurchat 8:27 PM Nov 8th
nursemaiden @AgencyNurse#Nurchat I wish I knew, I agree with red tray and
protected time however its staff numbers to dependency issues? 8:26 PM Nov 8th
mikkywatt @KevinHamPlymUni Does everyone obey the meal times though? We
had them on my final placement but they still got disturbed #nurchat 8:25 PM Nov
8th

14. NurChat RT @UKDietitian: #nurchat Just carried out yearly MUST Audit at our
Trust, now doing route-cause analysis as to why not completed. Suggestions to start
us? 8:25 PM Nov 8th
KevinHamPlymUni #Nurchat also encouraging visitors to visit at mealtimes to help
or encourage patients to eat 8:25 PM Nov 8th
AgencyNurse @kathjlo Surely the idea is to promote a healthy balanced diet?
#Nurchat 8:25 PM Nov 8th
kathjlo obviously this whole debate makes you think a little differently #nurchat 8:25
PM Nov 8th
McCandlish I agree about older pts being left unable to feed themselves. It is very
frustrating especially when wards are short staffed. #nurchat 8:25 PM Nov 8th
AgencyNurse @nursemaiden I have similar concerns - what practical things can we
do to combat this ? #Nurchat 8:24 PM Nov 8th
kathjlo i have had incidences where overweight patients may not be eating meals and
it gets over looked because they arnt going to starve #nurchat 8:24 PM Nov 8th
mikkywatt Me too RT @nursemaiden: #NurChat my concern is the elderly in
hospital unable to feed themselves and food being left #nurchat 8:23 PM Nov 8th
nursiedeb RT @AgencyNurse: RT @nursemaiden: #NurChat my concern is the
elderly in hospital unable to feed themselves and food being left #Nurchat 8:23 PM
Nov 8th
KevinHamPlymUni #Nurchat our local trust has protected mealtimes and the red tray
system 8:23 PM Nov 8th
AgencyNurse RT @nursemaiden: #NurChat my concern is the elderly in hospital
unable to feed themselves and food being left #Nurchat 8:23 PM Nov 8th

15. UKDietitian #nurchat Just carried out yearly MUST Audit at our Trust, now doing
route-cause analysis as to why not completed. Suggestions to start us? 8:23 PM Nov
8th
AgencyNurse @KevinHamPlymUni That sounds like a very minimal approach - do
they get put on any weight loss programme? #Nurchat 8:23 PM Nov 8th
NurChat thanks @Hhaylo, catch you soon :) #nurchat 8:22 PM Nov 8th
Hhaylo #nurchat sorry, have to go. Thanks and will read transcript tomorrow, hope
you all come up with some good solutions :-) 8:22 PM Nov 8th
AgencyNurse Anyone aware of community drives to identify and help with
malnourishment ? #Nurchat 8:22 PM Nov 8th
KevinHamPlymUni #Nurchat in my local trust if a patient is assessed as obese the
instructions is to give them a healthy eating booklet 8:21 PM Nov 8th
nursemaiden #NurChat my concern is the elderly in hospital unable to feed
themselves and food being left 8:21 PM Nov 8th
AgencyNurse @KevinHamPlymUni I agree we often forget the overweight pts -
obesity has it's own health implications #Nurchat 8:21 PM Nov 8th
NotFromBolton RT @AgencyNurse: RT @nursiedeb I think that we need to realise
patients are often malnourished prior to admission. Its a huge prob in bariatric pts
#Nurchat 8:21 PM Nov 8th
Gaggyy @KevinHamPlymUni Agreed! We shouldn't condone being size 0 OR size
sexy, SIZE HEALTHY all the way! #Nurchat 8:21 PM Nov 8th

16. kathjlo as likely to be as an underweight pateint. and yet we may even attempt to
reduce intake in this patient group #nurchat 8:20 PM Nov 8th
mikkywatt @Gaggyy Very true, was thinking of some of my older clients who
struggle to keep their trousers/skirts up when walking. #nurchat 8:20 PM Nov 8th
AgencyNurse RT @McCandlish: Have NICE produced guidelines in over nutrition?
#nurchat When I was looking recently I couldnt find any. #Nurchat 8:19 PM Nov 8th
kathjlo @AgencyNurse @nursiedeb i think that its highly unlikely that a bariatric
patient would be considered as malnourished but are just #nurchat 8:19 PM Nov 8th
nursiedeb @AgencyNurse I totally agree. Often the family is our greatest ally in
prevent malnourishment #nurchat 8:19 PM Nov 8th
KevinHamPlymUni #Nurchat most people in society are overweight or obese 8:18
PM Nov 8th
McCandlish Have NICE produced guidelines in over nutrition? #nurchat When I was
looking recently I couldn't find any. 8:18 PM Nov 8th
AgencyNurse RT @nursiedeb I think that we need to realise patients are often
malnourished prior to admission. Its a huge prob in bariatric pts #Nurchat 8:18 PM
Nov 8th
nursiedeb @NurChat also need to be aware that malnutrition isn't just caused by not
eating. Not eating the rght variety offoods is the issue #nurchat 8:18 PM Nov 8th
AgencyNurse @nursiedeb this is ridiculous - particularly when we are trying to
encourage ppl to eat and gain weight #Nurchat 8:17 PM Nov 8th
Gaggyy @mikkywatt But what about patients that favour baggy clothes? Or wear
them for hassle free dressing? #nurchat 8:17 PM Nov 8th

17. KevinHamPlymUni #Nurchat bariatric is the future 8:17 PM Nov 8th
mikkywatt @NurChat Decent food that people actually want to eat, makes a huge
difference #nurchat 8:17 PM Nov 8th
nursemaiden #NurChat hi sally from bristol sorry bit late 8:17 PM Nov 8th
NurChat RT @KevinHamPlymUni: #Nurchat Must isnt great at assessing or
suggesting care for patients who are overnourished #nurchat 8:17 PM Nov 8th
nursiedeb @NurChat I think that we need to realise patients are often malnourished
prior to admission. Its a huge prob in bariatric pts #nurchat 8:16 PM Nov 8th
AgencyNurse RT @KevinHamPlymUni: #Nurchat Must isnt great at assessing or
suggesting care for patients who are overnourished #Nurchat 8:16 PM Nov 8th
EmmaCarderRD @northwnutrition @McCandlish: MUST an assessment tool, not a
care plan so just beginning of sorting out a pts nutritional needs... #nurchat 8:16 PM
Nov 8th
mikkywatt Should be something in initial/ongoing nurse assessment about clothes
fitting, people often come into hospital wearing 2 big items #nurchat 8:15 PM Nov
8th
AgencyNurse @gerrybolger Lol - that would be fab, but please don't rush on my
account !! #Nurchat 8:15 PM Nov 8th
Gaggyy @NurChat More staff!!! :P #nurchat 8:15 PM Nov 8th
KevinHamPlymUni #Nurchat Must isn't great at assessing or suggesting care for
patients who are overnourished 8:15 PM Nov 8th

18. nursiedeb @NurChat Pts. families are often keen to bring in food they know their
relative will eat but are discouraged due to various regs. #nurchat 8:15 PM Nov 8th
gerrybolger @AgencyNurse no, but can put up a page tonight if that would help
http://t.co/s9ho6oYD will be the link give me 30 mins! #Nurchat 8:14 PM Nov 8th
NurChat so what CAN be done to really tackle malnutrition in pts?? #nurchat 8:14
PM Nov 8th
kathjlo it is not a magic wand and does not replace the need for good nursing care
and clinical observation #nurchat 8:14 PM Nov 8th
gerrybolger MUST is also only suitable for adults #nurchat 8:14 PM Nov 8th
northwnutrition RT @McCandlish: MUST is just an assessment tool, not a care plan
so its just the beginning of sorting out a pts nutritional needs... #nurchat 8:13 PM Nov
8th
AgencyNurse @gerrybolger do you hav details on your blog? #Nurchat 8:13 PM Nov
8th
gerrybolger RT @McCandlish: MUST is just an assessment tool, not a care plan so
its just the beginning of sorting out a pts nutritional needs.. #nurchat 8:13 PM Nov 8th
kathjlo Must is another piece of paper work put in place from the gods above so they
can say they are dealing with malnutrition! #nurchat 8:13 PM Nov 8th
KevinHamPlymUni #Nurchat hi all I'm Kevin lecturer in adult nursing in Plymouth
8:13 PM Nov 8th

19. AgencyNurse @McCandlish I agree - it's just the start needs to be followed through
with good planning and most importantly implementation #Nurchat 8:13 PM Nov 8th
NurChat RT @McCandlish: MUST is just an assessment tool, not a care plan so its
just the beginning of sorting out a pts nutritional needs... #nurchat 8:13 PM Nov 8th
gerrybolger I'm happy to share what we did & it was developed with RCN, BDA,
Water Uk & others but didn;t get uptake #nurchat 8:12 PM Nov 8th
AgencyNurse @gerrybolger that sounds interesting #Nurchat 8:12 PM Nov 8th
McCandlish MUST is just an assessment tool, not a care plan so its just the beginning
of sorting out a pts nutritional needs... #nurchat 8:12 PM Nov 8th
mikkywatt @AgencyNurse Absolutely, MUST score of 2-3, nothing done about it...
Hard to do on some people though, poor historians #nurchat 8:11 PM Nov 8th
nursiedeb RT @AgencyNurse: RT @MacMoomin: we use MUST but I agree.
Sometimes it is paid lip service & not linked to care or real life problem solving for
pts #Nurchat 8:11 PM Nov 8th
gerrybolger ... but for some odd reason never got finally implemented because it
needed patient weight (as we also aligned it to hydration #nurchat 8:10 PM Nov 8th
MacMoomin #nurchat back in a mo. Washing machine playing up! #darn 8:10 PM
Nov 8th
Gaggyy @AgencyNurse Agreed! Great tool, but is it always followed? I don't think
so... Is malnutrition more prevalent in geriatrics? #Nurchat 8:10 PM Nov 8th
Hhaylo @MacMoomin totally agree #nurchat 8:10 PM Nov 8th

20. gerrybolger @AgencyNurse I agree but only if we let it, we incorporated its
principles into a suggested nurse sensitive outcome indicator... #Nurchat 8:10 PM
Nov 8th
AgencyNurse RT @MacMoomin: we use MUST but I agree. Sometimes it is paid lip
service & not linked to care or real life problem solving for pts #Nurchat 8:10 PM
Nov 8th
Hhaylo @AgencyNurse Agree with paper exercise comment, snowed under with
documentation! #nurchat 8:09 PM Nov 8th
AgencyNurse @Hhaylo I like the addition of eyes and instinct - I think this is vital
#Nurchat 8:09 PM Nov 8th
MacMoomin #nurchat we use MUST but I agree. Sometimes it is paid lip service and
not linked to care or real life problem solving for patients. 8:09 PM Nov 8th
paulalouisexx #nurchat 3rd year nutrition and health student 8:09 PM Nov 8th
Hhaylo #nurchat we use malnutrition screening tool, good if used effectively with
dietetic support + eyes and instinct! 8:08 PM Nov 8th
McCandlish MUST #nurchat done on admission, which then leads to a food plan for
every pt - red amber or green, and potentially dietician referral. 8:08 PM Nov 8th
AgencyNurse MUST is a fabulous tool but all too often I see it being used only as a
paper exercise #Nurchat 8:07 PM Nov 8th
Gaggyy @NurChat Hey tweeps! Gage here :) An interesting topic! Mainly lurking as
on my Blackberry! #Nurchat 8:06 PM Nov 8th
AgencyNurse RT @NurChat: so tonight subject is nutrition- with 1/3 of pts at risk of
malnutrition how can we identify those at risk #Nurchat 8:05 PM Nov 8th

21. northwnutrition Hi to #nurchat. Anne from wirral- dietitian. Trying to join in with a
slowish connection 8:05 PM Nov 8th
lisadietitian RT @NurChat: #nurses #nursing #nurseuk tonight at 8pm we are
discussing nutrition via #NurChat http://t.co/5lZxsTsJ 8:05 PM Nov 8th
Hhaylo #nurchat Hi, Hayley in Bristol 8:04 PM Nov 8th
NurChat thanks to Kevin for tonight’s topic suggested from
@kevinhamplymuni#nurchat 8:04 PM Nov 8th
NurChat so tonight subject is nutrition- with 1/3 of pts at risk of malnutrition how can
we identify those at risk #nurchat 8:04 PM Nov 8th
MacMoomin #nurchat Kate in Hampshire. Community perspective. 8:03 PM Nov 8th
McCandlish Student Nurse (second year) in Nottingham - currently on an adult acute
medical ward #nurchat 8:03 PM Nov 8th
gerrybolger Gerry from London #nurchat 8:02 PM Nov 8th
AgencyNurse Hi all - Teresa here in Bristol #Nurchat 8:02 PM Nov 8th
nursiedeb @NurChat Hello it's Debbie from just outside Edinburgh #nurchat 8:02
PM Nov 8th
NurChat good evening all - lets start with introductions, who is out there this
evening?? #nurchat 8:01 PM Nov 8th

22. NurChat ... and bear in mind the NMC code of conduct and guidelines when tweeting
#nurchat 7:59 PM Nov 8th
NurChat Please remember as always that your tweets are all your own opinion and
not necessarily those of nurchat... #nurchat 7:58 PM Nov 8th