Quality statement 5: Review

Quality statement

People receiving nutrition support are offered a review of the indications, route, risks, benefits and goals of nutrition support at planned intervals.

Rationale

People's nutritional status is affected by a number of different factors and can therefore change rapidly. Regular review of the nutrition support care plan by a care professional enables the plan to be adapted to best meet the current needs of the person.

Quality measure

Structure: Evidence of local arrangements to ensure that people receiving nutrition support are offered a review of the indications, route, risks, benefits and goals of nutrition support at planned intervals.

Process: a) The proportion of people receiving nutrition support who have the indications, route, risks, benefits and goals of their nutrition support reviewed at planned intervals.

Numerator – the number of people in the denominator whose most recent review (subject to decision) is no later than planned after their last review.

Denominator – the number of people receiving nutrition support.

What the quality statement means for each audience

Service providers ensure there are systems in place for people receiving nutrition support to be offered a review of the indications, route, risks, benefits and goals of nutrition support at planned intervals.

Health and social are professionals review the indications, route, risks, benefits and goals of nutritional support in people who are receiving nutrition support at planned intervals.

Commissioners ensure that they commission services that have systems in place for people receiving nutrition support to have the indications, route, risks, benefits and goals of their nutrition support reviewed at planned intervals.

People receiving nutrition support have their need for nutrition support, their method of nutrition support and the risks, benefits and goals of their nutrition support reviewed at planned times.

Source guidance

NICE clinical guideline 32 recommendations 1.1.3, 1.5.1, 1.6.9, 1.7.3.

Data source

Structure: Local data collection.

Process: Local data collection.

Definitions

Nutrition support

This refers to recommendation 1.6.7 in NICE clinical guideline 32 on the overall nutrient intake needed in any nutrition support treatment and recommendation 1.3.3 on the appropriate method of providing nutritional support (oral, dietary advice, enteral or parenteral nutrition support, alone or in combination).

Planned intervals

The intervals between reviews will depend on the clinical needs of the person and the complexity of the nutrition support needed. Table 1 of NICE clinical guideline 32 provides a guide for intervals between reviews for people with more complex needs.

Clinical concern

A review should be carried out if there is clinical concern that includes, for example, unintentional weight loss, fragile skin, poor wound healing, apathy, wasted muscles, poor appetite, altered taste sensation, impaired swallowing, altered bowel habit, loose-fitting clothes or prolonged intercurrent illness.

Equality and diversity considerations

The review should take into account the person's dietary requirements, including those that vary according to religious and cultural beliefs.