This guideline covers identifying and caring for adults who are malnourished or at risk of malnutrition in hospital or in their own home or a care home. It offers advice on how oral, enteral tube feeding and parenteral nutrition support should be started, administered and stopped. It aims to support healthcare professionals identify malnourished people and help them to choose the most appropriate form of support.
In August 2017, we updated the links in the footnotes to recommendations 1.3.4 and 1.8.15. Recommendation 1.7.17 was also updated and links added to National Patient Safety Agency documents.
This guideline includes recommendations on:
- screening for malnutrition and the risk of malnutrition
- indications for nutrition support
- what nutrition support to give
- monitoring of nutrition support
- oral nutrition support
- enteral tube feeding
- parenteral nutrition
Who is it for?
- All healthcare workers in hospital and the community who are directly involved in patient care
- People who are malnourished or at risk of malnutrition in hospital or in their own home or a care home and their families and carers
Is this guideline up to date?
We reviewed the evidence in July 2017. We found no new evidence that affects the recommendations in this guideline.
Guideline development process
This guideline was previously called nutrition support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and 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. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.