Simple nutrition program improves outcomes
Long-term care/geriatrics
Simple nutrition program improves outcomes
Supplements with meds boost compliance
Sometimes it’s not what you do but when you do it that determines whether a treatment plan succeeds. Unintentional weight loss and pressure ulcers decrease the quality of life for many long-term care patients. Now, a simple program that provides nutrient-dense supplements at the same time medications are passed rather than at snack or mealtimes produces excellent outcomes as well as cost savings.
Health Care Facilities in Lima, OH, has used the Med Pass program for nursing home residents at nutritional risk. "The Med Pass program is an aggressive alternative to traditional between-meal supplement programs for patients at high nutritional risk," says Gretchen Robinson, MS, RD, FADA, corporate dietician for Health Care Facilities. Robinson uses TwoCal HN, a high-nitrogen liquid nutrition supplement from the Ross Products division of Columbus, OH-based Abbott Laboratories. "Two ounces of the supplement given four times daily provides patients with 475 Kcal and 19g of protein," she notes. (For protocols developed by the American Dietetic Association in Chicago for unintentional weight loss and pressure ulcer healing, see p. 43.)
In a pilot study of 15 nursing home residents identified as being at nutritional risk, Robinson found that the Med Pass program produced excellent outcomes at a cost of only $1.11 per patient per day, almost half the cost of traditional nutritional supplements. Results for the 15 patients participating in the 16-week study include:
• Seven of 15 residents gained six to 10 pounds.
• Weight stabilized in seven patients.
• Two patients’ chronic, open wounds healed.
"Using medication pass times rather than snack times for boosting nutrition has several advantages," says Robinson. "Because only a small volume is given per dose, patients tolerate it well and find that it doesn’t interfere with their appetite for meals. Compliance is also better because patients see the supplement more as a medication rather than an optional snack." Other benefits of the Med Pass program include cost savings associated with waste reduction from partially consumed or refused nourishment.
Robinson notes that the Med Pass program also is appropriate for hospice and home health patients. "Anytime we can enhance overall nutrition, offering supplements at medication time boosts compliance and increases the likelihood that patients will get the full benefit of nutritional supplements," she notes, adding that because the TwoCal HN is lactose and gluten free it meets Kosher standards. "Sometimes, the supplement is used for hospice patients who have given up just for comfort measures."
However, she cautions that Med Pass may not be appropriate for all patients. "The program can be harmful if not properly monitored and administered. Patients on this program should have very specific goals on their care plans for weight gain, or wound healing, so that case managers and clinicians can assess when the patient should come off the program." In addition, the supplement is not well-suited for certain patients, such as brittle diabetics. "The supplement is very high in protein and is not appropriate for patients with protein restricted diets," she notes.
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