In the same way that a healthy diet can influence clear skin, it can also have a positive effect on how well the skin fights off wounds. The epidermis is, after all, the body’s front-line defense against all environmental attacks. So the healthier it is, the easier it will be to prevent, manage and heal bedsores and pressure ulcers.
Thanks to the editors at the Association of Nutrition and Foodservice Professionals, there are several guidelines to take under consideration when developing a nutrition plan for patients at risk of pressure ulcer development. They include the following:
1. Screen and assess the nutritional status of every individual at risk of pressure ulcers in each health care setting. Since under-nutrition is a reversible risk factor for pressure ulcer development, early identification and management of under-nutrition is very important. Individuals at risk of pressure ulcer development may also be at risk of under-nutrition, and so should be screened for nutritional status.
1.1 Use a valid, reliable and practical tool for nutritional screening that is quick and easy to use and acceptable to both the individual and health care worker.
1.2 Have a nutritional screening policy in place in all health care settings, along with recommended frequency of screening for implementation.
Refer each individual with nutritional risk and pressure ulcer risk to a registered dietitian and also, if needed, to a multidisciplinary nutritional team that includes a registered dietitian, a nurse specializing in nutrition, a physician, a speech and language therapist, an occupational therapist, and when necessary a dentist.
If the nutritional screening identifies individuals as being prone to develop pressure ulcers or to be malnourished or at nutritional risk, then a more comprehensive nutritional assessment should be undertaken by a registered dietitian or a multidisciplinary nutritional team. Nutritional support should be offered to each individual with nutritional risk and pressure ulcer risk.
2.1. Provide nutritional support to each individual with nutritional risk and pressure ulcer risk, following the nutritional cycle. This should include:
- – Nutritional assessment
- – Estimation of nutritional requirements
- – Comparison of nutrient intake with estimated requirements
- – Provide appropriate nutrition intervention, based on appropriate feeding route
- – Monitoring and evaluation of nutritional outcome, with reassessment of nutritional status at frequent intervals while an individual is at risk. Individuals may need different forms of nutritional management during the course of their illness.
2.2. Follow relevant and evidence based guidelines on enteral nutrition and hydration for individuals at risk of pressure ulcers, who show nutritional risks or nutritional problems.
2.3. Offer each individual with nutritional risk and pressure ulcer risk a minimum of 30-35 kcal per kg body weight per day, with 1.25-1.5 g/kg/day protein and 1 ml of fluid intake per kcal per day.
And, to help monitor the progress of wound healing, don’t hesitate to contact the staff at WoundRounds. We would be happy to talk to you about the tools available to provide better care and ultimately, better outcomes for patients.
