Abstract
Study design:
A multi-centre, cross-sectional survey.
Objectives:
To establish and compare the resources allocated against existing national standards, and to document current nutritional screening practices.
Setting:
Spinal cord injury centres (SCICs) in the United Kingdom and the Republic of Ireland.
Methods:
After obtaining research ethics committee approval, 12 SCICs in the United Kingdom and the Republic of Ireland were surveyed by a postal questionnaire. Data collected included the number of whole time equivalent (WTE) staff available, whether a nutrition team was present and the use of nutritional screening tools in the SCIC.
Results:
Eleven (92%) SCICs responded. In total there were 482 allocated beds, and the average numbers of patients per WTE staff (s.d.), including consultants, nurses, dietitians, physiotherapists, occupational therapists and psychologists, were recorded. Eight centres used a nutritional screening tool, and only two centres had a clinical nutrition team.
Conclusion:
The resources allocated to nutritional care in SCICs appear to be very limited. This suggests that malnutrition will continue to be under-recognised and under-treated. There is a clear need for additional resources to address the nutritional needs of this special population group. Each SCIC should ensure regular access to nutritional advice, and the establishment of local nutrition support teams should be a priority.
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References
Brotherton A, Simmonds N, Stroud M . Malnutrition Matters: Meeting Quality Standards in Nutritional Care. BAPEN: Redditch, 2010.
Lean M, Wiseman M . Malnutrition in hospitals still common because screening tools are underused and poorly enforced. BMJ 2008; 336: 290.
NICE. The Management of Pressure Ulcers in Primary and Secondary Care: A Clinical Practice Guideline. NICE: London, 2005.
Council of Europe Committee of Ministers. Resolution RESAP on food and nutritional care in hospitals. https://wcd.coe.int/ViewDoc.jsp?id=85747, 2003.
NICE. Nutrition Support in Adults: Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition. NICE: London, 2006.
Consortium for Spinal Cord Medicine. Early Acute Management in Adults with Spinal Cord Injury: A Clinical Practice Guideline for Health-Care Providers. Paralyzed Veterans of America: Washington, 2008.
Royal College of Physicians. Chronic Spinal Cord Injury: Management of Patients in Acute Hospital Setting: National Guidelines. Royal College of Physicians: London, 2008.
MASCIP. Management of the Older Person With a New Spinal Cord Injury. MASCIP: Middlesex, 2010.
Cheshire DJE, Coats DA . Respiratory and metabolic management in acute tetraplegia. Paraplegia 1966; 4: 1–23.
American Dietetic Association. Spinal Cord Injury (SCI) Evidence-Based Nutrition Practice Guideline 2009. http://www.adaevidencelibrary.com (accessed April 2010).
Joint Standard Development Groups of the South England Review Group. Standards for Patients Requiring Spinal Cord Injury Care 2003. http://www.mascip.co.uk/standardssciPDF (accessed April 2010).
Elia M . Screening for Malnutrition: A Multidisciplinary Responsibility. Development and Use of the Malnutrition Universal Screening Tool (MUST) for Adults. BAPEN: Redditch, 2003.
Wong SS, Derry F, Harini S, Grimble G, Forbes A . How nutritional risk is assessed and managed in patients with spinal cord injuries (SCI) – results from a UK multicentre study. Top Spinal Cord Inj Rehabil 2011; 16: 19–20.
Dijkers M . Importance of the continuity of staffing in inpatient spinal cord injury rehabilitation. Arch Phys Med Rehabil 2010; 91: E17–E18.
Cox SA, Weiss SM, Posuniak EA, Worthington P, Prioleau M, Heffley G . Energy expenditure after spinal cord injury: an evaluation of stable rehabilitating patients. J Trauma 1985; 25: 419–423.
Joint Standard Development Groups of the South England Review Group. Standard for Patients Requiring Spinal Cord Injury Care (Revised 2010) 2010. http://www.secscg.nhs.uk/EasySiteWeb/getresource.axd?AssetID=99975&type=full&servicetype=Attachment (accessed 20 November 2010).
NHS Carers. How Agenda for Change Works, NHS Employers (2011). http://www.nhsemployers.org/PayAndContracts/AgendaForChange/Pages/Afc-AtAGlanceRP.aspx (accessed 28 February 2011).
NHS employer. National Profile for Dietetics 2011. http://www.nhsemployers.org/PayAndContracts/AgendaForChange/NationalJobProfiles/Documents/Dietetics.pdf (accessed 21 July 2011).
Thomas B, Bishop J . Manual of Dietetic Practice. Blackwell Publishing: Oxford, 2007.
Wong SS, Derry F, Sherrington K, Gerogery G . An audit to evaluate the use of nutrition screening tool in the National Spinal Injury Centre in Stoke Mandeville Hospital, Buckinghamshire Hospitals NHS Trust. Proc Nutr Soc 2009; 68 (OCE1): E53.
Acknowledgements
We thank Dr Allison Graham, Dr Joan Gandy and Dr Maureen Coggrave for reviewing the manuscript. We also thank the following persons who provided information for this study: Anthony Twist, The Robert Jones and Agnes Hunt Orthopaedics and District Hospital; Philippa Bearne, Salisbury District Hospital; Heather Nunn, Southport and Formby General Hospital; Louise Bentley, Musgrave Park Hospital; Kim Sheil and Lorna Fitzsimons, National Rehabilitation Hospital; Lynsey Clode and Sian Gruffudd, Rockwood Hospital; Karen Wiles, James Cook University Hospital; and Dr. Angela Gall, Prof. Michael Craggs, Judith Susser, Royal National Orthopaedic Hospital. Part of the study data were presented at the Nutrition Society annual meeting in July 2009 at University of Surrey, UK, and the International Spinal Cord Society annual meeting in June 2011. This project was partly funded by an unrestricted grant from Abbott Nutrition. University College London (UCL) Staff receive support from the Comprehensive Biomedical Research Centre funding awarded to UCL and its partner Trust by the National Institute for Health Research.
Author contributions: SW—protocol development, data analysis, manuscript preparation; FD—protocol development, clinical supervision, manuscript revision; GKG—academic supervision, manuscript revision; AF—academic supervision, manuscript preparation and revision.
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Wong, S., Derry, F., Grimble, G. et al. How do spinal cord injury centres manage malnutrition? A cross-sectional survey of 12 regional centres in the United Kingdom and Ireland. Spinal Cord 50, 132–135 (2012). https://doi.org/10.1038/sc.2011.118
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DOI: https://doi.org/10.1038/sc.2011.118
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