Nutrition & Foodservice Edge Magazine - September/October 2023 - 10

NUTRITION FOR WOUND HEALING: INSIGHTS
FOR FOODSERVICE MANAGERS
breakdown or a pressure injury. The pressure injuries were
listed by stage and then prioritized based on severity as well
as length of time they had the wound. "
Saari continued: " After creating the list, the dietitian would
work backwards and review every patient with a pressure
injury. Each pressure injury patient had a full nutrition
assessment done to ensure that their nutrition care plan
covered their calories, protein, and fluid needs daily. Stage
3 and 4 pressure injuries would be placed on a high protein,
high calorie diet to give them sufficient calories to heal
wounds. The dietitian also went around with the wound care
nurse to evaluate each wound in person. "
While it may be rare for a CDM, CFPP or an RD to go around
with the wound care nurse to make rounds, it can be a
valuable learning opportunity. As Saari notes, " Seeing a
wound in person is much different than simply reading
chart notes on it. Your heart and compassion really open
up when you see wounds that are 5 centimeters deep and
tunnelling. You begin to understand that impact that your
nutrition care plan has on a patient. "
Lisa Hugh also described her experiences in QAPI projects:
" At first, the facility only reported the number and types of
wounds. Over time, we did several projects which focused
on improving outcomes by ensuring compliance with the
facility's policies and procedures. "
Hugh describes how she regularly did audits focusing
on documentation as part of QAPI. She asked questions
like: " Were wounds documented on the initial nursing
assessment as well as the initial nutrition assessment? If not,
why not? Was an RD consult initiated when a new wound
was observed? If not, why not? Were ordered supplements
documented on the treatment administration record? Were
refusals or poor intake documented appropriately? " She
also focused on auditing when doing patient visits on wound
rounds, noting any concerns related to dietary services.
Hugh took the information from these audits and discussed
them in monthly QA meetings. Then " the interdisciplinary
team would decide on corrective actions. Strategies included
in-service, educational events, changes in policies, changes
in documentation practices, and changes in communication
systems. "
CDM, CFPPs can act as an integral part of these meetings
and strategies. For example, CDM, CFPPs might have special
insights about resident meal preferences and lack of intake,
and be able to suggest fortified foods or products that could
work for the resident. They can also be involved in inservices
and educational sessions.
How do these actions benefit the facility? Hugh notes, " This
ongoing process quickly changed the quality of the reporting
as well as patient and staff outcomes. Many of the clinical
staff obtained advanced training in wound care, the facility
reported less skin breakdown, quicker wound healing, and
lower costs related to wound care supplies. "
How's that for a win-win?!
THE BOTTOM LINE
There's no one-size-fits-all protocol or supplement to
manage wounds - interventions must be individualized
according to a resident's current intake, risk of malnutrition,
chronic conditions, and other factors. However, there are
general clinical guidelines for evidence-based care, and
as a foodservice manager you contribute significantly to
outcomes by creating meals that align with these guidelines.
By working with dietitians and other members of the patient
care team on wound healing initiatives, you can improve
the prognosis of patients and ensure cost savings for your
facility. E
REFERENCES
Scan QR code to view the list
of resources for this article.
CHRISSY CARROLL, MPH, RD |
chrissy@snackinginsneakers.com
Chrissy Carroll is a registered dietitian, freelance writer, and brand
consultant based in central Massachusetts.
10 NUTRITION & F OOD SER VICE EDGE | SEPTEMBER-OCTOBER 2023
https://www.anfponline.org/news-resources/nutrition-and-foodservice-magazine/qr-code-landing-pages/september-october-2023
Nutrition & Foodservice Edge Magazine - September/October 2023

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