Implementing the Care Plan for Patients Diagnosed with Malnutrition—Why Do We Wait?

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The implementation of a nutrition care plan (NCP) for malnourished patients in ICU and peri-operative protocols is fairly straightforward. The problem, waiting to implement the NCP, is more evident in the medicine units where integration of the plan with the overall clinical care plan may not be as straightforward. With the prevalence and problems related to malnutrition in hospitalized patients finally recognized and standardized diagnostic criteria available for early identification, there should not be any doubt that implementation of a NCP is a clinically and morally appropriate course of therapy.

Early and adequate intervention of well-documented nutritional deficits may be delayed for a number of reasons. There may be a focus on medical diagnosis first then later on the patients nutrition needs. The care team may be waiting for the pt to regain appetite or have improved symptoms. Many times, a pt may be scheduled for testing that requires a NPO situation, then the testing is delayed and then delayed some more.

These are not simple cut and dry scenarios that can be solved by the book. There are ethical issues involved; what is best for the patient and when. There is a call to develop policies and protocols to alleviate ambiguity related to delaying or proceeding with the NCP. The question "Why wait?" needs to be answered.

Journal of the AND, Implementing the Care Plan for Patients Diagnosed with Malnutrition—Why Do We Wait? 2016.

FD

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