Hospital Observation Scenarios

Wasting money is a big problem, yet it is not the only one; wasting the catering associate’s time is another. Catering associates only have about two minutes to spend in a patient’s room. That may seem like plenty of time to get an order and move on to the next patient. However, by the time the caterer describes the menu, diet, and the Always Available Menu, by the time the patients decide what they want, it is time to for the catering associate to move on. There is very little time to search for a menu and describe the process of ordering. Therefore, this leads to confusion for patients.

There is a need to identify the level and type of support an individual requires when eating and drinking. Any support while eating or drinking is to be provided respecting the service user’s human dignity, while the carer is exhibiting warmth and a calm attitude. The care plan informs whether the service user is able to feed him/herself, or needs assistance. Many service users will feed themselves when starting their meal, but will get tired and will then require assistance. The hands of service users with Parkinson’s may have to be gently directed so that they manage eating independently. The carer may need to cut the food for the service user. Service users with chewing difficulties, or swallowing precautions, or a history of choking need to be supervised while eating. Of course, these service users will also get a soft diet. Service users living with dementia may reject food which to them resembles to gruesome things (e.g., they may think meat bits in a dark sauce are cocroaches), therefore person-centered support is important. Service users with learning disabilities may find it hard to estimate distances, so the carer will make sure plates and glasses are well within their reach.

Describe how and when to seek additional guidance about and individual’s choice of food and drink.

Carolyn Tobin Director of Food and Nutrition & Environmental Services at Pennsylvania Hospital has a wide variety of education. She has a degree in Food Service management, Speech Pathology and Audiology and Nutrition. And she doesn’t eat correct. She has been in hospital Nutrition for the past 20 years. Prior to that she worked in food service at universities like Lehigh University and Chestnut Hill collage. She has also spent some of her early career in hotels and casinos. Out of all her jobs working in hospitals she favors the most.

In this assignment I will be choosing and describing a service user for my case study and I’m going to explain how some factors such as medical disorders, life style and many more may have influenced their dietary intake. Due to the data protection I will not be using their real name.

Looking back at the nutritional food plan for the week for my individual which I previously done in my P3, I will be looking back at the kind of food and exercise the individual was doing in that week. This will then link into my D2- as in my previous P5 for this unit I had to create my own healthier diet plan for my individual and I will be evaluating how my plan may help the individual’s health.

After consultation with the client, a healthy diet will be the focus. The client is not overweight, exercises adequately and consistently, and is generally in very good health. The client reports eating ‘junk food’, not eating breakfast, and not getting the recommended daily servings of each food group as endorsed by the United States Department of Agriculture (USDA).

By creating these small adjustments in the patient’s nutritional care, the patient’s independence and dignity are maintained. The patient, such as a stroke patient in rehabilitation, may also be reluctant to take an active role in their nutritional care so firm encouragement by the carer is needed. The presentation and availability of food and drink must also be assessed to deliver person-centred care (BAPEN REF). Patients may forego food if it looks unappetizing so it is important to serve meals that are visually appealing. Serving appetizing meals may also protect against malnutrition (BAPEN REF). Although protected mealtimes ensure that food and drink is given to every patient with minimal distraction, some patients may become hungry or thirsty in the hours between meals. Making food, like sandwiches or toast, and water available to patients may reduce the risk of malnutrition and dehydration and improve patients’ wellbeing (BAPEN REF). Good nutritional care achieved by person-centred practice means not only reducing risk of malnutrition and fluid imbalance but improving the patient’s quality of life,

The following Quality Assessment was completed prior to a surprised inspection by the Office of Inspector General (OIG), when management received notice that an expired box lunch was left in the nourishment refrigerator in the Emergency Room department. This prompted Nutrition and Food Service managers to initiate a QA of every nourishment area in the hospital.

At the providence hospital I observed at the two different setting. First I observed at the St. Catherine's rehabilitation center which provide long-term rehabilitation care. The physical therapist at the sub-acute care provide treatment to the chronic ill patient and geriatric patients. The goal of the sub-acute physical therapist is to restore basic mobility and movements.

The Maryland Dining halls have been an unfortunate and familiar scene in my first two years at the University of Maryland. I dreamed of the day when I can no longer be required to be on the meal plan and looked forward to making delicious and fresh meals. But, after my first week of living without a food plan I realized I wasn’t prepared to function properly without a food plan. Often, I relied on unhealthy and inexpensive alternatives that satisfied my hunger. I didn’t know the first thing about living a balanced and healthy life without a food plan and I was glad that I’m not the only one with this problem.

The five day dietary assessment gave us a chance to see what the patient was consuming and how often. Five to six days a week the patient had fruits, juices, eggs, meat, fish, poultry, and vegetables other than starches during a meal time. Just as often she was having, milk, yogurt, potatoes, rice, other starches, cheese, and soda with sugar with both meals and snacks. In between meals she was enjoying cookies, cake, pies, and pastries at least three times a week, and sugar free gum every day. A few times a month the patient would have Coffee or tea with added sugar or flavorings, sports or energy drinks, and candy during both meals and snacks. Three things that she never consumes are cereals, diet soda, and gum with sugar. C.S. states she

The Evidence Analysis Library is an online resource of a combination of nutritional research providing guidance in making evidence based decisions; providing answers with given grades that indicate overall strength or weakness of such conclusion. Other useful resources available from AND are the Nutrition Care Manual that help practitioners increase the use of the problem solving method such as the nutrition care process. One important, indispensible tool is the International Dietetics and Nutrition Terminology (IDNT) that enforces standardized language across all the RDs. The IDNT’s main function is to describe and document the RDs practice of care in medical records, coding and billing. Positions papers from AND represent the academy’s current stand point, such as goals, mission, values and strategies. Such decisions are generated from current data, facts and research literature available. Position papers may be redacted or replaced as new evidence is being generated, in attempt to keep up with current

Nevertheless, nurses and clinicians can help prevent malnutrition. Education is an essential component of care; especially for male caregivers, who plan meals, shop for food and cook. When providing teaching, the goal is to increase awareness of good nutrition, enhance motivation to eat well, facilitate the opportunity to take action, increase the environmental support for action Contento (2011). It is important to assess the physical environment (Aesthetics, Noise level, table height and style) when addressing the barriers to good nutrition. The American Dietetic Association (Dorner et al., 2010), in its position paper on diet in long-term care, recommends the liberalizing of restricted

I completely agreed with you about the safety issues that are encountered daily in the surgical areas. There has been implementation of safety intervention to remedy these concerns on patient safety. In most cases, nurses are rushed with the consequences that patients are not properly prepped in the pre-op areas prior to the surgical procedures. Personally I have been in same problem of being rushed to bring the patient in the room. In this particular incident, I just finished a case in another room and have not interviewed this particular patient. I informed the Anesthesiologist and the surgeon to give me few minutes to interview the patient prior to transfer to the operating room. To everybody’s surprise the surgeon wheeled the patient