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Nutrition - communication

Nursing staff are at the heart of the communication process. They play a key role in seeing that appropriate care and support planning is in place based on identifying patients/service users’ needs.

They ensure that by maintaining the quality of record keeping they communicate effectively with the health and social care team. This includes identifying measurable goals and agreeing evaluation dates so that progress can be monitored.

One of the first steps in identifying patients/service users' needs is to use a validated screening tool, such as the Malnutrition Universal Screening Tool, to identify people at risk (BAPEN 2003). Staff use the assessment to develop a care/support plan and engage with patients/service users to identify their requirements and preferences. Staff monitor the plan against these individual nutritional needs with particular attention to those most vulnerable to nutritional risk.

Communication issues have been identified as contributing to a large number of patient safety incidents (Joint Commission Resources 2007). Problems typically arise at shift or patient handovers and/or involve ambiguous or poorly recorded information in patient files. Status can also inhibit how information is transferred.

Many safety critical industries have recognised the importance of communication and have introduced ways of addressing these factors. Briefing tools such as SBAR (Situation, Background, Assessment, Recommendation) give opportunities for team members to share information and speak up (NHS Institute for Innovation and Improvement 2008; Risky Business 2011, World Health Organization 2009). Use of communication tools, such as the one developed by Health Improvement Scotland (2011), can help minimise the risk to the continuity of care caused by poor discharge planning.

Communicating with patients in meaningful ways is an essential aspect of patient centred care. This is even more crucial in the context of dementia when usual ways of communicating start to breakdown. When people with dementia require significant support effective communication is important to how well they eat and enjoy mealtime experiences (NHS Dumfries and Galloway 2012).

See also:

References

These resources were last accessed on 29 July 2013. Some of them are in PDF format - see how to use PDF files.

BAPEN (2003) MUST toolkit. Redditch: BAPEN.  

Joint Commission Resources (2007) Improving hand-off communication. Illinois: Joint Commission Resources (Made available by Google eBooks).

Healthcare Improvement Scotland (2011) Nutritional care communication tool. Edinburgh: Healthcare Improvement Scotland.

NHS Dumfries and Galloway (2012) Communication and Mealtimes Toolkit Helping people with dementia to eat, drink & communicate. A guide for carers (PDF 7.8MB), Dumfries: NHS Dumfries and Galloway.

NHS Institute for Innovation and Improvement (2008) SBAR Situation – Background – Assessment – Recommendation. NHS Institute website.  

World Health Organization (2009) Human factors in patient safety. Review of topics and tools. Report for methods and measures working (PDF 1.10MB). Geneva: WHO.

Further resources

Learning materials on the application of MUST are signposted at Knowledge and skills.
 
National Patient Safety Agency (2009) Nutrition factsheets. 10 key characteristics of good nutritional care in hospital: 07 prevalence of malnutrition. London: NPSA.

Royal College of Nursing (2010) Principles of Nursing Practice: Principle E
The Principles describe what everyone can expect from nursing practice, whether colleagues, patients, their families or carers. Principle E focuses on communication, handling feedback, record keeping, reporting and monitoring. This page brings together RCN resources which are particularly relevant to this Principle.