nice guidelines oral nutritional supplements

,�hA)��)�@��t��=g��kg�Lf�s��>f� 0��!g�`�Dc� ��LX��`��@s J��w2�X^��l�e�á�o?�HJiu��~��d��O�q�SC2��Ǖ϶�l�ZO�੽��ag�. 0000015894 00000 n Diabetes and other endocrinal, nutritional and metabolic conditions. 0000014544 00000 n 10 - service organisation staff training and staff roles. only in the management of actual vitamin or mineral deficiency; they are not to be prescribed as dietary supplements or as a general "pick-me-up". 0000015051 00000 n Appendix Six Meta-Analyses Oral versus Standard Care. 0000143994 00000 n Surveillance report 2017 - Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition (2006) NICE guideline CG32 [Internet] Review London: National Institute for Health and Care Excellence (UK); 2017 Jul 27. Denominator – the number of people in a care setting who meet the criteria for screening (see statement 1). Nutrition Support for Adults: Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition. Denominator – the number of people or the carers of people managing their own artificial nutrition support. 0000014712 00000 n (see page 5) and should reflect local and national policy and guidance . This also helps to manage significant patient safety issues, such as nutrition support not continuing when it is required or people being given inappropriate food for their circumstances. PURPOSE OF THE GUIDELINES The guidelines aim to assist GPs and other community prescribers on the use of ONS. a) and b) Local data collection. What are the benefits of patients (in hospital or the community, including older people) identified as at high risk of malnutrition by a screening tool such as MUST being offered either oral nutritional supplements compared with: a) dietary modification and/or food fortification; or b) dietary modification and/or food fortification together with dietary counselling, in terms of determining complications, survival, length of hospital stay, quality of life and cost effectiveness? 0000194931 00000 n The National Institute for Health and Care Excellence (NICE) guideline CG32 (NICE, 2006: updated 2017) provide criteria to determine the level of RFS risk. 0000016567 00000 n c) Evidence of local arrangements to ensure that care settings have access to suitably calibrated equipment to enable accurate screening to be conducted. Objectives. 2. He received approximately 570 kcal overnight on day 0 and on day 1, 1140 kcals on day 2, and 1710 kcal on day 3, and then the feeds stopped and a 1500 kcal light diet was started on day 4. The trend of results is important, Baseline, then every 2–4 weeks, depending on results, Deficiency common, especially when increased losses, People most at risk when anabolic. With the lack of evidence the GDG have considered in detail this problem and have instead carefully developed the guidance for monitoring by expert clinical practice and consensus opinion. Found inside – Page 459National Institute for Health and Care Excellence (NICE) 2006 Clinical guidelines CG32. Nutrition support in adults ... Stratton RJ, Elia MA 1999 Critical, systematic analysis of the use of oral nutritional supplements in the community. 0000048617 00000 n 0000024904 00000 n Found inside – Page 162London Health Sciences Centre (2012) Neurological monitoring standards of nursing care in CCTC (SONC). ... NICE (2006) Nutrition support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition. 10. 0000011220 00000 n 0000016482 00000 n As per NICE (2006) guidelines; Found insideTABLE 14.3 Society Guidelines on the Use of EPA-Enriched Oral Nutritional Supplements in Cancer Patients Society Recommendation(s) Grading AND (AND) (Thompson Dietary supplements or Medical Food Supplement (MFS) containing fish oil If ... Training and education should be accessible to people who have difficulties reading or speaking English and those who need information in non-written form. 0000195854 00000 n For people screened who are not malnourished or at risk of malnutrition, the results should be recorded in their care plan but they do not need specific nutrition support goals. Numerator – the number of people in the denominator whose screening results and nutritional support goals (if applicable) are communicated in writing. Further research is needed to ascertain whether an educational intervention (for example, three 1-week modular courses, over 6 months) for all healthcare professionals, in particular medical and nursing staff including those who work with people with dementia, would have an affect on patient care (that is, affect on nutritional status, length of hospital stay, frequency of GP visits, complications and quality of life) compared with no formal education? 0000194369 00000 n 8 Malnutrition is particularly common among older people; it has been reported to affect 29%-61% of the . The Group regards these recommendations as the most important research areas to improve NICE guidance and patient care in the future. Current evidence suggests that oral supplemental nutrition** plus dietary advice may improve nutritional status in older people affected by undernutrition. Nutrient intake from oral, enteral or parenteral nutrition (including any change in conditions that are affecting food intake), Daily initially, reducing to twice weekly when stable, To ensure that patient is receiving nutrients to meet requirements and that current method of feeding is still the most appropriate. 0000026842 00000 n 11. a history of alcohol abuse or drugs including insulin, chemotherapy, antacids or diuretics. 0000029004 00000 n %%EOF 0000014796 00000 n 0000026421 00000 n 0000059293 00000 n Clinical guideline [CG32] 0000018842 00000 n * Intrinsic capacity is defined by the WHO guideline as the combination of the individual's physical and mental, including psychological, capacities. Dietary supplements for oral use. 8 - nutrition support in adults/parenteral nutrition. trailer The review should take into account the person's dietary requirements, including those that vary according to religious and cultural beliefs. 0000025747 00000 n 0000020022 00000 n They should also be competent in managing their own nutrition delivery system, including the equipment used to deliver the feed, and storing the feed in an appropriate environment. 0000012858 00000 n Denominator – the number of people receiving nutrition support. • Alternative methods can be used to supplement dietary intake without prescribing supplements. Is tube in working order (all pieces intact, tube not blocked/kinked)? The following is a useful guide: 1-2 years, 200 kcal (840 kJ); 3-5 years, 400 . There is no clear evidence available regarding the long- and short-term benefits of clinical monitoring in terms of prevention of complications and survival. using feeds and supplements that meet full energy and nitrogen needs, as they may not provide adequate micronutrients and minerals when only used in a supplementary role. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. 0000027093 00000 n Oral Nutritional Supplements are only prescribable for the management of the following conditions as recommended by the Advisory Committee on Borderline Substances (ACBS). They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Quick reference guide to prescribing Oral Nutritional Supplements (ONS) for adults in primary care [pdf] 403KB Found inside – Page 15London : NPSA . tinyurl.com/ npsasafetyalert NICE ( 2006 ) Nutrition Support in Adults : Oral Nutrition Support ... uk/guidance/CG32 Pratt , R.J. et al ( 2007 ) Epic 2 : nationalevidenced based guidelines for preventing healthcare ... 0000032198 00000 n 11. Clinical Guideline 32 Nutrition support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition.44. 0000119844 00000 n 0000050644 00000 n a) The proportion of people in care settings who are screened for the risk of malnutrition using a validated screening tool. Numerator – the number of people in the denominator who are screened monthly for the risk of malnutrition. 0000030644 00000 n This group of people should be monitored every. 1 Practice pharmacists should familiarise themselves with the guideline when managing malnutrition in practice. 0000024820 00000 n The prescription should be reviewed according to the person's progress, and care should be taken when: delivery of a nutritionally complete feed via a tube into the stomach, duodenum or jejunum, all essential vitamins and trace elements, any of the following methods to improve nutritional intake: fortified food with protein, carbohydrate and/or fat plus minerals and vitamins; snacks; oral nutritional supplements; altered meal patterns; and the provision of dietary advice, intake from any food, oral fluid, oral nutritional supplements, enteral and/or parenteral nutrition support and intravenous fluid, Babies, children and young people’s experience of healthcare, Obstructive sleep apnoea–hypopnoea syndrome and obesity hypoventilation syndrome, Anaphylaxis: assessment and referral after emergency treatment, Sickle cell disease: acute painful episode, Genomic biomarker-based treatment for solid tumours, Metastatic malignant disease of unknown primary origin, Suspected cancer recognition and referral, Acute coronary syndromes: early management, Acute coronary syndromes: secondary prevention and rehabilitation, Cardiovascular disease: identifying and supporting people most at risk of dying early, Prophylaxis against infective endocarditis, Diabetes and other endocrine, nutritional and metabolic conditions, Endocrine, nutritional and metabolic conditions, Lifestyle weight management services for overweight or obese adults, Lifestyle weight management services for overweight or obese children and young people, Dyspepsia and gastro-oesophageal reflux disease, Surgical management of otitis media with effusion in children, Preventing sexually transmitted infections and under-18 conceptions, Intrapartum care for women with existing medical conditions, Intrapartum care for women with obstetric complications, Neonatal infection: antibiotics for prevention and treatment, Developmental follow-up of children and young people born preterm, Specialist neonatal respiratory care in preterm babies, Pregnancy and complex social factors: service provision, Urinary incontinence and pelvic organ prolapse in women, Antimicrobial prescribing for common infections, Bites and stings – antimicrobial prescribing, Bronchiectasis (non-cystic fibrosis) – antimicrobial prescribing, Cellulitis and erysipelas – antimicrobial prescribing, Clostridioides difficile infection – antimicrobial prescribing, Self-limiting respiratory tract and ear infections – antibiotic prescribing, Bacterial meningitis and meningococcal septicaemia in under 16s, Prevention and control of healthcare-associated infections, Antisocial behaviour and conduct disorders in children and young people, Obsessive-compulsive disorder and body dysmorphic disorder, Attachment difficulties in children and young people, Common mental health disorders in primary care, Dementia, disability and frailty in later life: mid-life approaches to delay or prevent onset, Harmful sexual behaviour among children and young people, Health of people in the criminal justice system, Learning disabilities and behaviour that challenges, Mental health problems in people with learning disabilities, Coexisting severe mental illness and substance misuse: assessment and management in healthcare settings, Rehabilitation for adults with complex psychosis, Service user experience in adult mental health services, Transition between community or care home and inpatient mental health settings, Social care for older people with multiple long-term conditions, Urinary incontinence in neurological disease, Oral health improvement for local authorities and their partners, Community pharmacies: promoting health and wellbeing, Vitamin D: supplement use in specific population groups, Mental wellbeing and independence in older people, Social and emotional wellbeing for children and young people, Smokeless tobacco cessation: South Asian communities, Smoking: tobacco harm-reduction approaches, End of life care for people with life-limiting conditions, Looked-after babies, children and young people, Transition from children's to adults' services, Care and support of people growing older with learning disabilities, Excess winter deaths and illnesses associated with cold homes, Coexisting severe mental illness and substance misuse: community health and social care services, People’s experience in adult social care services, Service delivery, organisation and staffing, Emergency and acute medical care in over 16s: service delivery and organisation, Safe staffing for nursing in adult inpatient wards in acute hospitals, Managing medicines for people receiving social care in the community, Transition between inpatient hospital settings and community or care home settings for adults with social care needs, Opioids for pain relief in palliative care, Safe midwifery staffing for maternity settings, Controlled drugs: safe use and management, Managing long-term sickness absence and capability to work, Workplace health: policy and management practices, Current: Nutrition support in adults overview, Nutrition support in adults – everything NICE says in an interactive flowchart, Documentation and communication of results and nutrition support goals, Self-management of artificial nutrition support, protocol for nutritional, anthropometric and clinical monitoring of nutrition support, protocol for laboratory monitoring of nutrition support, Accident prevention (see unintentional injuries among under-15s), Acute coronary syndromes (see chest pain), Acute hospitals (adult inpatient wards), safe staffing for nursing, Acute myocardial infarction (see acute coronary syndromes: early management), ADHD (see attention deficit hyperactivity disorder), Adult carers (see supporting adult carers), Adverse drug reactions (see drug allergy), Allergy, food (see food allergy in children and young people), Allergy, severe reaction (see anaphylaxis), Amyotrophic lateral sclerosis (see motor neurone disease), Anaemia in chronic kidney disease (see chronic kidney disease), Ankylosing spondylitis (see spondyloarthritis), Antibiotic prescribing for diabetic foot infections (see foot care for people with diabetes), Antibiotics for neonatal infection (see neonatal infection), Antibiotics in respiratory tract and ear infections, Antimicrobials for bronchiectasis (non-cystic fibrosis), Antimicrobials for cellulitis and erysipelas, Antisocial personality disorder (see personality disorders), Anxiety (see generalised anxiety disorder), Axial spondyloarthritis (see spondyloarthritis), Behaviour that challenges and learning disabilities, Benign prostatic hyperplasia (see lower urinary tract symptoms in men), Blackouts (see transient loss of consciousness), Bladder infection (see urinary tract infections), Body dysmorphic disorder (see obsessive-compulsive disorder), Borderline personality disorder (see personality disorders), Bowel cancer prevention (see colonoscopic surveillance), Bowel incontinence (see faecal incontinence), Brain cancer (see brain tumours and metastases), Breast cancer, early and locally advanced, Breastfeeding (see maternal and child nutrition), Cancer of unknown primary origin (see metastatic malignant disease of unknown primary origin), Catheter-associated UTIs (see urinary tract infections), Challenging behaviour and learning disabilities, Child maltreatment (see child abuse and neglect), Childbirth (see fertility, pregnancy and childbirth), Children's attachment (see attachment difficulties in children and young people), Children's experience of care (see babies, children and young people's experience of healthcare), Children's palliative care, for people with life-limiting conditions (see end of life care for people with life-limiting conditions), Cholelithiasis, cholecystitis and choledocholithiasis (see gallstone disease), Chronic fatigue syndrome (see myalgic encephalomyelitis (or encephalopathy)), Chronic obstructive pulmonary disease–obstructive sleep apnoea-hypopnoea syndrome overlap syndrome (see obstructive sleep apnoea–hypopnoea syndrome and obesity hypoventilation syndrome), Cold homes, reducing preventable excess winter deaths (see excess winter deaths and illnesses associated with cold homes), Colorectal cancer prevention (see colonoscopic surveillance), Community-acquired pneumonia (see pneumonia), Complex psychosis, rehabilitation for adults (see rehabilitation for adults with complex psychosis), Complex social factors and pregnancy: service provision, Conduct disorders and antisocial behaviour in children and young people, COPD–OSAHS overlap syndrome (see obstructive sleep apnoea–hypopnoea syndrome and obesity hypoventilation syndrome), Cough (see self-limiting respiratory tract and ear infections – antibiotic prescribing), Criminal justice system, health of people in, Deep vein thrombosis (see venous thromboembolism), Dental perioperative care (see perioperative care), Dental services, local authority improvement approaches (see oral health improvement for local authorities and their partners), Diverticulitis (see diverticular disease), Diverticulosis (see diverticular disease), Dual diagnosis (see coexisting severe mental illness and substance misuse: assessment and management in healthcare settings), Dual diagnosis (see coexisting severe mental illness and substance misuse: community health and social care services), Early-onset neonatal infection (see neonatal infection), End of life care for infants, children and young people (see end of life care for people with life-limiting conditions), Endocarditis prophylaxis (see prophylaxis against infective endocarditis), Enteral nutrition (see nutrition support in adults), Experience of care (babies, children and young people), Falls in older people (see preventing falls in older people), Fibroids, uterine (see heavy menstrual bleeding), Fractured neck of femur (see hip fracture), Gastric cancer (see oesophageal and gastric cancer), Gastroenteritis in children (see diarrhoea and vomiting in children), Gastro-oesophageal reflux disease and dyspepsia, Glue ear (see surgical management of otitis media with effusion in children), Gynaecological conditions (see urogenital conditions), Haematemesis (see acute upper gastrointestinal bleeding), Haematological cancers (see blood and bone marrow cancers), Healthcare-associated infections, prevention and control, Heartburn (see dyspepsia and gastro-oesophageal reflux disease), Histology-independent treatment for solid tumours, Hospital-acquired pneumonia (see pneumonia), Hypercholesterolaemia, familial (see familial hypercholesterolaemia), Hypercholesterolaemia, non-familial (see cardiovascular disease prevention), Hyperkinetic disorder (see attention deficit hyperactivity disorder), Hyperphosphataemia in chronic kidney disease (see chronic kidney disease), Incontinence, urinary in neurological disease, Independence and mental wellbeing in older people, Indoor air quality at home (see air pollution), Infant feeding (see maternal and child nutrition), Inflammatory bowel disease (see Crohn's disease), Inflammatory bowel disease (see ulcerative colitis), Interstitial lung disease (see idiopathic pulmonary fibrosis), Intraoperative care (see perioperative care), Labour, care for women with existing medical conditions (see intrapartum care for women with existing medical conditions), Labour, care for women with obstetric complications (see intrapartum care for women with obstetric complications), Larynx, mouth and throat cancer (see upper aerodigestive tract cancer), Learning disabilities, mental health problems, Leukaemia (see blood and bone marrow cancers), Life-limiting conditions, end of life care (see end of life care for people with life-limiting conditions), Lipid modification (see cardiovascular disease prevention), Long-term pain (see chronic pain (primary and secondary)), Long-term sickness absence and capability to work, Lymphoma (see blood and bone marrow cancers), Maternity settings, safe midwifery staffing, Medicines adherence (see medicines optimisation), Meningitis, bacterial and meningococcal septicaemia, Menorrhagia (see heavy menstrual bleeding), Mental health disorders (common) in primary care, Mental health services, adult service user experience, Mental illness (severe) and substance misuse, coexisting (see coexisting severe mental illness and substance misuse: community health and social care services), Metabolic conditions (see endocrine, nutritional and metabolic conditions), Monitoring ill patients (see acutely ill patients in hospital), Mouth, larynx and throat cancer (see upper aerodigestive tract cancer), Multiple long-term conditions (see multimorbidity), Multiple pregnancy (see twin and triplet pregnancy), Myocardial infarction without ST-segment elevation (see chest pain), Myocardial infarction, secondary prevention and rehabilitation (see acute coronary syndromes: secondary prevention and rehabilitation), Neurological disease, urinary incontinence, Nocturnal enuresis (see bedwetting in children and young people), Non-STEMI (see acute coronary syndromes: early management), Non-ST-segment elevation myocardial infarction (see chest pain), Nose conditions (see ear, nose and throat conditions), Nutritional conditions (see endocrine, nutritional and metabolic conditions), OHS (see obstructive sleep apnoea–hypopnoea syndrome and obesity hypoventilation syndrome), Older people with social care needs and multiple long-term conditions (see social care for older people with multiple long-term conditions), Older people: independence and mental wellbeing, OSAHS (see obstructive sleep apnoea–hypopnoea syndrome and obesity hypoventilation syndrome), Otitis media (acute) (see self-limiting respiratory tract and ear infections – antibiotic prescribing), Otitis media with effusion, surgical management in children, Outdoor air quality and health (see air pollution), Overactive bladder (see urinary incontinence), Overweight or obese adults, lifestyle weight management services, Overweight or obese children and young people, lifestyle weight management services, Pain, chronic (see chronic pain (primary and secondary)), Palliative care, for people with life-limiting conditions (see end of life care for people with life-limiting conditions), Parenteral nutrition (see nutrition support in adults), People with learning disabilities, mental health problems, Persistent pain (see chronic pain (primary and secondary)), Postoperative care (see perioperative care), Pre-eclampsia (see hypertension in pregnancy), Pregnancy (see fertility, pregnancy and childbirth), Pregnancy, preventing teenage (see preventing sexually transmitted infections and under-18 conceptions), Pregnancy, twins and triplets (see twin and triplet pregnancy), Premature labour and birth (see preterm labour and birth), Premature ovarian insufficiency (see menopause), Preoperative care (see perioperative care), Primary chronic pain (see chronic pain (primary and secondary)), Psoriatic arthritis (see spondyloarthritis), Psychosis with coexisting substance misuse (see coexisting severe mental illness and substance misuse: assessment and management in healthcare settings), Psychosis, complex, rehabilitation for adults (see rehabilitation for adults with complex psychosis), Pulmonary embolism (see venous thromboembolism), Pyelonephritis (see urinary tract infections), Reactive arthritis (see spondyloarthritis), Renal failure, acute (see acute kidney injury), Renal failure, established (see chronic kidney disease), Renal replacement therapy and renal transplant (see chronic kidney disease), Respiratory syncytial virus infection (see bronchiolitis in children), Respiratory tract and ear infections (self-limiting), antibiotic prescribing, Secondary chronic pain (see chronic pain (primary and secondary)), Septicaemia, meningococcal and bacterial meningitis (see bacterial meningitis and meningococcal septicaemia), Severe mental illness and substance misuse, coexisting (see coexisting severe mental illness and substance misuse: community health and social care services), Sexually transmitted infections, prevention, Shoulder replacement (see joint replacement), Sinusitis (see self-limiting respiratory tract and ear infections – antibiotic prescribing), Skin cancer prevention (see sunlight exposure: risks and benefits), Sleep apnoea (see obstructive sleep apnoea–hypopnoea syndrome and obesity hypoventilation syndrome), Social care services, people's experience, Social factors (complex) in pregnancy: service provision, Sore throat (see self-limiting respiratory tract and ear infections – antibiotic prescribing), Spinal cord compression, metastatic (see metastatic spinal cord compression), STEMI (see acute coronary syndromes: early management), Stomach cancer (see oesophageal and gastric cancer), Substance misuse and severe mental illness, coexisting (see coexisting severe mental illness and substance misuse: community health and social care services), Surgical site infection (see prevention and control of healthcare-associated infections), Suspected neurological conditions recognition and referral (see neurological conditions), Teenage pregnancy prevention (see preventing sexually transmitted infections and under-18 conceptions), Termination of pregnancy (see abortion care), Throat conditions (see ear, nose and throat conditions), Throat, larynx and mouth cancer (see upper aerodigestive tract cancer), Tobacco cessation (smokeless): South Asian communities, Type 1 and type 2 diabetes in children and young people, Unstable angina (see acute coronary syndromes: early management), Urological conditions (see urogenital conditions), Vaccinations (see immunisation for children and young people), Weight management services (lifestyle) for overweight or obese adults, Weight management services (lifestyle) for overweight or obese children and young people, Winter deaths and illnesses associated with cold homes (see excess winter deaths and illnesses associated with cold homes), Young offender institutions, health of people in, Young people's experience of care (see babies, children and young people's experience of healthcare), assess and reduce the environmental impact of implementing NICE recommendations, Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition, Gastroparesis in adults: oral erythromycin, Tegaderm CHG securement dressing for vascular access sites, Biopatch for venous or arterial catheter sites, CORTRAK 2 Enteral Access System for placing nasoenteral feeding tubes, nutrition support in adults quality standard, Malnutrition Universal Screening Tool (MUST), Nutrition support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition. 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