Diabetes Health Pack and Nutritional Support

Nutritional therapy

Our nutritional status plays a central role in diseases, especially in inflammation, surgery and trauma. The aim of nutritional therapy is to maintain or improve the nutritional status of a patient and to avoid malnutrition and nutrient deficiencies through the targeted administration of nutrients.

Nutritional therapy can take place either orally, e.g. with the help of oral food supplements, enterally using feeding tubes, or parenterally, i.e. by administering the nutrients intravenously.

The type of nutritional therapy depends largely on the patient's condition. The underlying clinical picture and the needs of the patient are decisive. For example, patients in the intensive care unit have different nutrient requirements than patients who are undergoing cancer therapy or who have to be dialyzed.

Malnutrition in the G-DRG system - new complex code

Interview with PD Dr. Michael Adolph, Medical Director Nutrition Management, on the background and effects on hospitals.

Processes in nutritional therapy


Nutritional therapy encompasses all forms of nutritional support, from food fortification for patients who cannot or cannot eat enough to full parenteral nutrition when patients cannot meet their nutritional needs by oral or enteral routes. Our body reserves are normally able to compensate for short periods of fasting. For patients who are already malnourished or who are at risk of malnutrition, even short periods without adequate nutrient intake can worsen the clinical outcome and increase the risk of morbidity and mortality.

Studies have shown that around 20 - 50% of patients in the hospital are malnourished and require nutritional therapy. Nutritional therapy is based on a structured process. The various process steps make it possible to derive the correct form of nutritional support by recording the nutritional situation of the patient and thus to design a therapy tailored to the needs of the patient, which, if necessary, can even be continued beyond the hospital stay.

Needs assessment

With the help of routine nutritional screening, patients can be systematically examined for the risk or the presence of malnutrition. On the basis of the results, the doctor decides which form of nutritional therapy is necessary and how the nutrition should be administered in the best possible way. If necessary, the appropriate nutritional therapy is prescribed by the doctor.

Access

Appropriate access is necessary for enteral and parenteral nutrition therapy: Enteral nutrition can be administered, for example, by means of a gastric tube or with the aid of a percutaneous endoscopic gastrostomy tube (PEG). Parenteral nutrition is administered either via a peripheral vein, a central venous catheter or an implantable port.

preparation

Enteral nutrition products are usually available ready-to-use as sip feed or tube feed. Parenteral nutrition can be administered either via individual components or via ready-to-use multi-chamber bags. Vitamins and trace elements are usually added to them. With some patients it is necessary to adjust the diet to the individual needs (compounding). These special regimens are manufactured by a pharmacy or an industrial service provider.

application

Appropriate application systems are necessary for the administration of enteral or parenteral nutrition. Special administration systems ensure that there is no unintentional mix-up of enteral and intravenous applications, thus increasing safety for everyone involved. The use of safety systems (ENFit ™) is recommended for the application of enteral tube feeding. ENFit ™ is the new design standard for enteral application systems that meets market requirements for maximum patient safety. Specific enteral / parenteral sets are available for the application of nutritional solutions with the aid of infusion pumps. Thanks to this, the application can be designed safely and efficiently.

Discharge and supply management

In some cases, it is necessary to continue nutritional therapy even after inpatient treatment. This is the case, for example, with oncological patients or short bowel patients. A discharge management system coordinates all activities and organizes the handover to a resident nursing service. This ensures that nutritional therapy can be continued in an uncomplicated, smooth and sustainable manner.