Quality standard
Quality statement 2: Treatment
Quality statement 2: Treatment
Quality statement
People who are malnourished or at risk of malnutrition have a management care plan that aims to meet their complete nutritional requirements.
Rationale
It is important that nutrition support goes beyond just providing sufficient calories and looks to provide all the relevant nutrients that should be contained in a nutritionally complete diet. A management care plan aims to provide this and identifies condition specific circumstances and associated needs linked to nutrition support requirements.
A nutritionally complete diet can improve speed of recovery and contribute to reducing admissions to hospital and length of hospital stays.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
a) Evidence of local arrangements to ensure that people who are malnourished or at risk of malnutrition are offered a management care plan that aims to meet their complete nutritional requirements including underlying conditions, specific circumstances and associated needs.
b) Evidence of a local written protocol that all management care plans aim to provide complete nutritional requirements.
c) Evidence of local arrangements to ensure that care settings are able to provide appropriate nutrition support including artificial feeding when needed.
Process
The proportion of people who are malnourished or at risk of malnutrition who receive a management care plan that aims to meet their complete nutritional requirements.
Numerator – the number of people in the denominator who receive a management care plan that aims to meet their complete nutritional requirements.
Denominator – the number of people who are malnourished or at risk of malnutrition.
What the quality statement means for different audiences
Service providers ensure that systems are in place for all people who are malnourished or at risk of malnutrition to have a management care plan that aims to meet their complete nutritional requirements.
Health and social care professionals give all people who are malnourished or at risk of malnutrition a management care plan that aims to meet their complete nutritional requirements.
Commissioners ensure they commission services that give people who are malnourished or at risk of malnutrition a management care plan that aims to meet their complete nutritional requirements.
People who have malnutrition (not getting enough calories and nutrients, such as protein and vitamins, to meet the body's needs) or who are at risk of malnutrition receive a management care plan that, in combination with any food they are able to eat, aims to provide all the nutrients their body needs.
Source guidance
Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition. NICE guideline CG32 (2006, updated 2017), recommendations 1.3.3 (key priority for implementation), 1.3.4, 1.6.7
Data source
Structure
a) and b) Local data collection.
Process
Local data collection.
Outcome
Local data collection.
Definitions
Management care plan
This refers to the nutrition support provided alongside other dietary intake that aims to provide a person's complete nutritional requirements. The plan also takes into account any underlying conditions and the individual's specific circumstances and associated needs.
Complete nutritional requirements
This includes providing adequate energy, proteins, fluids, electrolytes, minerals, micronutrients and fibre, taking into account personal factors including physical activity levels.
Equality and diversity considerations
People's special dietary requirements, including those that are consistent with religious and cultural beliefs, should be taken into account irrespective of the underlying reason for these requirements.