Nurses ‘must’ control of the nutritional needs of stroke patients

Abstract

The aim of this observational study was to review nutritional practice within an acute stroke unit (ASU) and compare practice against National Institute for Health and Clinical Excellence (NICE) guidance, National Patient Safety Agency (NPSA) guidelines, and the National Stroke Agenda. 'Observations of Care', a well recognized approach and part of the Royal College of Nursing clinical leadership programme, was undertaken along with a traditional audit to review nutritional care in the ASU. Usually undertaken by persons outside of the team to prevent bias, in this situation the bias was minimized as the auditor was new to the team. Current practice was evaluated and it was important for the team to have ownership of the assessment process. This article also reviews the prevalence of malnutrition in hospitals and the importance of nutritional assessment, the use of screening tools and types of diet that best maintain optimum outcomes. Patients who have experienced a stroke can face a range of problems that influence dietary intake. On admission, 16-31% are already malnourished.

Malnutrition, Health and the Role of Machine Learning in Clinical Setting

“…It is estimated that nearly 20% of patients with cerebrovascular accidents suffer from malnutrition (8). Malnutrition in stroke patients is directly associated with increased length of hospitalization and decreased rehabilitation improvements (9,10). Mechanistically, these dietary proteindeficient patients exhibit altered genomic expression, leading to decreased hippocampal fiber plasticity and poor recovery (11).…”

Malnutrition in Patients with Acute Stroke

“…However, a substantial proportion of the variation may also be attributed to the heterogeneity of nutritional assessment methods [8, 9]. The prevalence of malnutrition rises with increased length of hospitalization and with decreased functional improvement during rehabilitation [8, 13]. In a studyon 104 patients with acute stroke, protein-energy malnutrition was present in 16.3% on admission, and this rate increased to 26.4% by day 7 and to 35% at day 14 in those who remained hospitalized [8].…”

“…Besides dysphagia, factors that contribute to poor nutritional intake include reduced level of consciousness, poor oral hygiene, depression, reduced mobility, and arm or facial weakness [13]. Poststroke depression reduces appetite and has a deleterious influence on recovery of daily living activities.…”

Malnutrition in Stroke Patients: Risk Factors, Assessment, and Management

“…Other important factors that should not be overlooked when assessing the risk of developing malnutrition in stroke patients include reduced level of consciousness, reduced mobility, facial or arm weakness, and poor oral hygiene (25). Type and severity of stroke are considered major risk factors for malnutrition especially that subarachnoid hemorrhage produce a hypercatabolic state in the body (26, 27).…”