Page 61 - Petelin, Ana, ur. 2021. Zdravje starostnikov / Health of the Elderly. Zbornik povzetkov z recenzijo / Book of Abstracts. Koper: Založba Univerze na Primorskem/University of Primorska Press
P. 61
ited lecture prehrana in zdravje starejših odraslih | nutrition and health of the elderly
Health effects of nutritional treatment at residents in nursing
home on permanent tube feeding
Irena Hren, Katarina Rakuša
Dom starejših občanov Šmihel, Novo mesto, Slovenia
Introduction. Inadequate nutrition in older persons contributes to the progres-
sion of many diseases, and is important contributing factor in development of
sarcopenia and frailty. Loss of skeletal muscle mass occurs during aging, disease,
or inactivity. At those on permanent tube feeding, it is often due to all three fac-
tors. Early nutrition intervention can reduce complication rates, length of hos-
pital stay, readmission rates, mortality and costs. Enteral nutrition support is a
medical treatment, that can be defined as a life-sustaining therapy. Decisions on
route, content, and management of nutritional support are best made by multi-
disciplinary nutrition teams. Home enteral nutrition is usually started during a
hospital stay and continued as a long-term home therapy. Although blender-
ized tube diets are less effective and less safe than commercially produced solu-
tions and should not be utilized in patients on home enteral nutrition, they are
still popular. In 2018 we identified insufficient feeding of patients on permanent
tube feeding. In order to improve the long-term nutritional support of these us-
ers we contacted the management of the largest regional nursing home Novo
mesto (NH Nm) and began mutual cooperation. In this paper, we will provide
an overview of some recorded health effects of nutritional treatment at users
on permanent tube feeding as result of this cooperation.
Methods. For the two years period before and after first nutritional manage-
ment in our Clinic for clinical nutrition (ACP) we plan to review the trend of
body weight, the frequency of: bedsores, antibiotic use, referrals to specialists
and acute infections (including Covid-19).
Results. From all patients discharged and placed in nursing homes, in the last
three years on average 28 % were transferred to the NH Nm. On average
38 percutaneous gastrostomes were inserted to the patients in our hospital
for various reasons. In 2018, lung (35 %) and neurological diseases (in 35 %),
followed by brain damage (6.5 %) were the most frequent indications for the
placement of feeding tube. As result of mutual work, a home-made tube di-
ets in NH Nm were replaced by a commercially produced enteral formula and
a scale to weighing the immobile residents was purchased. Since December
2018, we performed eight ACPs opened only for the NH Nm residents. A to-
tal of 61 treatments were performed on 19 users, with an average age of 75
years. On average, the number of admissions to a local hospital decreased for
1.6 times.
Discussion and conclusion. In the nutritional care of residents in nursing home in-
terinstitutional cooperation comes also to the forefront. This can contribute,
as in our case, to better health outcomes. Use of enteral formula prescribed
from nutritional support team improve weight, decrease hospital admissions
and beneficially affect on health of users on a permanent tube feeding.
Keywords: health effects, nutritional management, tube feeding,
interinstitutional cooperation
59
Health effects of nutritional treatment at residents in nursing
home on permanent tube feeding
Irena Hren, Katarina Rakuša
Dom starejših občanov Šmihel, Novo mesto, Slovenia
Introduction. Inadequate nutrition in older persons contributes to the progres-
sion of many diseases, and is important contributing factor in development of
sarcopenia and frailty. Loss of skeletal muscle mass occurs during aging, disease,
or inactivity. At those on permanent tube feeding, it is often due to all three fac-
tors. Early nutrition intervention can reduce complication rates, length of hos-
pital stay, readmission rates, mortality and costs. Enteral nutrition support is a
medical treatment, that can be defined as a life-sustaining therapy. Decisions on
route, content, and management of nutritional support are best made by multi-
disciplinary nutrition teams. Home enteral nutrition is usually started during a
hospital stay and continued as a long-term home therapy. Although blender-
ized tube diets are less effective and less safe than commercially produced solu-
tions and should not be utilized in patients on home enteral nutrition, they are
still popular. In 2018 we identified insufficient feeding of patients on permanent
tube feeding. In order to improve the long-term nutritional support of these us-
ers we contacted the management of the largest regional nursing home Novo
mesto (NH Nm) and began mutual cooperation. In this paper, we will provide
an overview of some recorded health effects of nutritional treatment at users
on permanent tube feeding as result of this cooperation.
Methods. For the two years period before and after first nutritional manage-
ment in our Clinic for clinical nutrition (ACP) we plan to review the trend of
body weight, the frequency of: bedsores, antibiotic use, referrals to specialists
and acute infections (including Covid-19).
Results. From all patients discharged and placed in nursing homes, in the last
three years on average 28 % were transferred to the NH Nm. On average
38 percutaneous gastrostomes were inserted to the patients in our hospital
for various reasons. In 2018, lung (35 %) and neurological diseases (in 35 %),
followed by brain damage (6.5 %) were the most frequent indications for the
placement of feeding tube. As result of mutual work, a home-made tube di-
ets in NH Nm were replaced by a commercially produced enteral formula and
a scale to weighing the immobile residents was purchased. Since December
2018, we performed eight ACPs opened only for the NH Nm residents. A to-
tal of 61 treatments were performed on 19 users, with an average age of 75
years. On average, the number of admissions to a local hospital decreased for
1.6 times.
Discussion and conclusion. In the nutritional care of residents in nursing home in-
terinstitutional cooperation comes also to the forefront. This can contribute,
as in our case, to better health outcomes. Use of enteral formula prescribed
from nutritional support team improve weight, decrease hospital admissions
and beneficially affect on health of users on a permanent tube feeding.
Keywords: health effects, nutritional management, tube feeding,
interinstitutional cooperation
59
