Quality standard
Quality statement 5: Review
Quality statement 5: Review
Quality statement
People receiving nutrition support are offered a review of the indications, route, risks, benefits and goals of nutrition support at planned intervals.
Rationale
People's nutritional status is affected by a number of different factors and can therefore change rapidly. Regular review of the nutrition support care plan by a care professional enables the plan to be adapted to best meet the current needs of the person.
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
Evidence of local arrangements to ensure that people receiving nutrition support are offered a review of the indications, route, risks, benefits and goals of nutrition support at planned intervals.
Process
a) The proportion of people receiving nutrition support who have the indications, route, risks, benefits and goals of their nutrition support reviewed at planned intervals.
Numerator – the number of people in the denominator whose most recent review (subject to decision) is no later than planned after their last review.
Denominator – the number of people receiving nutrition support.
What the quality statement means for different audiences
Service providers ensure there are systems in place for people receiving nutrition support to be offered a review of the indications, route, risks, benefits and goals of nutrition support at planned intervals.
Health and social are professionals review the indications, route, risks, benefits and goals of nutritional support in people who are receiving nutrition support at planned intervals.
Commissioners ensure that they commission services that have systems in place for people receiving nutrition support to have the indications, route, risks, benefits and goals of their nutrition support reviewed at planned intervals.
People receiving nutrition support have their need for nutrition support, their method of nutrition support and the risks, benefits and goals of their nutrition support reviewed at planned times.
Source guidance
Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition. NICE guideline CG32 (2006), recommendations 1.1.3, 1.5.1, 1.6.9, 1.7.3
Data source
Structure
Local data collection.
Process
Local data collection.
Definitions
Nutrition support
This refers to recommendation 1.6.7 in NICE's guideline on nutrition support for adults on the overall nutrient intake needed in any nutrition support treatment and recommendation 1.3.3 on the appropriate method of providing nutritional support (oral, dietary advice, enteral or parenteral nutrition support, alone or in combination).
Planned intervals
The intervals between reviews will depend on the clinical needs of the person and the complexity of the nutrition support needed. Table 1 of NICE's guideline on nutrition support for adults provides a guide for intervals between reviews for people with more complex needs.
Clinical concern
A review should be carried out if there is clinical concern that includes, for example, unintentional weight loss, fragile skin, poor wound healing, apathy, wasted muscles, poor appetite, altered taste sensation, impaired swallowing, altered bowel habit, loose-fitting clothes or prolonged intercurrent illness.
Equality and diversity considerations
The review should take into account the person's dietary requirements, including those that vary according to religious and cultural beliefs.