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Resources for Nurse &
Trainee Nurse Associates

Malnutrition Pathway Primary Care Network Portal

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Nurse Associates support registered Nurses to enable them to be able to focus on the more complex clinical care, record clinical observations, promote health and well-being to all patients and advise patients on general healthcare and promote self-management where appropriate. They are ideally placed to carry out screening for risk of malnutrition, to signpost to resources to support nutritional intake and to refer to other healthcare professionals and local community and voluntary sector services.

Remain alert to subjective indicators of malnutrition

Such as unexplained weight loss, dysphagia, fatigue. Further information can be found HERE

Determining malnutrition risk & giving dietary advice

Knowing a patient’s weight, weight history and height can be helpful in using a validated tool to screen for malnutrition. Current weight and height will allow Body Mass Index (BMI) to be calculated and documented. Comparison of current weight with weight 3 months/6 months ago will identify weight loss. The BAPEN ‘MUST’ self-screening tool is an easy access tool to determine malnutrition risk which can be used by professionals, patients and carers: BAPEN 'MUST' SCREENING TOOL

Patients at risk of malnutrition should be given advice on optimising food intake, encouraged to increase the frequency of eating and taking nourishing drinks and advised on food fortification if feasible and practical for them. The Malnutrition Pathway has produced a useful list of questions and resources to help obtain information to assist in selecting the most appropriate course of action and dietary advice resources for the patient: ‘Initiating conversations about unintentional (unplanned) weight loss and diet’ GO TO RESOURCE SHEET

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Helping patients

It is important that patients understand the importance of adopting dietary advice, particularly if they have historically followed healthy eating plans and patterns. Those at high risk, who are unable or anticipated to be unable to achieve adequate nutritional intake through these first line ideas should be referred/considered for oral nutritional supplements (ONS) on prescription. Dietitians are best placed to carry out holistic nutritional assessments. Where appointment waiting times are lengthy, GPs, Practice Nurses and Practice Pharmacists can support with assessing patients and initiating ONS where appropriate, to prevent a further deterioration in the patient’s nutritional status.

The Malnutrition Pathway COPD resources

the Malnutrition Pathway COPD book

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The Malnutrition Pathway patient and carer resources: Green, Yellow and Red leaflets

the Malnutrition Pathway Green Leaflet, low malnutrition risk, Eating Well

GREEN: Eating Well for those at low risk of malnutrition; how to eat a balanced diet.

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YELLOW: Your Guide to Making the Most of Your Food for those at medium risk of malnutrition; how to fortify foods.

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RED: Nutrition Drinks (known as oral nutritional supplements) for those at high risk of malnutrition and who have been prescribed oral nutritional supplements. This leaflet gives advice on how best to incorporate oral nutritional supplements into the diet.

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Managing symptoms that interfere with eating

Reduced appetite, feeling full after eating small amounts, unexplained weight loss

Dry mouth, sore mouth, chewing difficulties, breathlessness

Loss of Taste/taste changes

Swallowing issues

Altered bowel habit – diarrhoea or constipation

Bothering smells

Heartburn, Reflux, Nausea, Vomiting

Anaemia

Fatigue, feeling tired