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PP167-MON RELATIONSHIP OF NUTRITION STATES AND BODY CONDITION OF ELDERLY HEMODIALYSIS PATIENTS LIVING NURSING HOME
S184 controlled by hydraulic pressure and heat stimulation though maintaining circulation blood volume. In this study, secretion of catecholamine shows no rise in the bathing. It is suggested that bathing before breakfast can ameliorate the cold body and dropsy without burden of the function of stomach. Disclosure of Interest: None Declared
PP166-MON AN AUDIT OF THE DIETETIC MANAGEMENT OF REFEEDING SYNDROME IN A DUBLIN TEACHING HOSPITAL G. Corrigan1 , C. O’ Neill1 , N. Connolly1 , O. Deeney1 , E. Fanning1 , H. Guiden1 , R. Hannon1 , A. Lyons1 , K. McElligott1 , S. McMahon1 , C. Moreau1 , A. Shaw1 . 1 Nutrition & Dietetics, Beaumont Hospital, Dublin, Ireland Rationale: Our enteral feeding audit (2011) highlighted variation in dietetic management of patients at risk of refeeding syndrome (RS). We aimed to investigate this further and improve uniformity of practice. Methods: A questionnaire, based on a similar UK study [1] was completed (2012) by all dietitians (n = 17), including case scenarios to elicit RS risk and recommendations for caloric, micronutrient and electrolyte provision. Results were presented to the department. A medical audit highlighted poor awareness of RS and an interdisciplinary working group was formed. A hospital RS policy was developed and dietetic practice was re-audited in 2013 (n = 15). Results: Substantial variation was seen in perceived risk of RS with 53% of respondents correctly identifying high RS risk as per NICE2 . Extreme and moderate risk were identified in 71% and 64% of respondents respectively. Identification of RS risk improved at all levels on re-audit, with 87%, 80% and 67% of dietitians identifying high, extreme and moderate risk respectively. Recommendations for initial caloric provision improved; 80% correctly prescribing 10 kcal /kg in high risk and 50% giving 5 kcal /kg in extreme risk, compared to 47% and 35% respectively on initial audit. Some overfeeding at extreme risk was still evident on re-audit, while underfeeding in high risk ceased. Recommendations for appropriate route and dose of thiamine and multivitamin supplementation markedly improved (80% vs 24%). Provision of full electrolyte requirements on feed initiation, as per NICE2 was deemed unsafe. Conclusion: Dietetic identification of RS risk, caloric provision and micronutrient recommendations improved at all levels of risk, with some scope for increased uniformity. References [1] G. Wagstaff (2011). Dietetic practice in refeeding syndrome. J Hum Nutr Diet, 24, pp. 505 515. 2. NICE National Institute for Health and Clinical Excellence. Nutr Support in Adults. Clin guideline 32, 2006.
Poster presentations PP167-MON RELATIONSHIP OF NUTRITION STATES AND BODY CONDITION OF ELDERLY HEMODIALYSIS PATIENTS LIVING NURSING HOME M. Yoshiko1 , K. Yukie2 , S. Yuzuru1 . 1 Sato Junkanki Hospital, Matsuyama, Matsuyama-shi, Ehime-ken, 2 Tokyo Healthcare University, Tokyo, Japan Rationale: We investigated nutritional status and body composition in elderly hemodialysis patients who are living in the nursing home. Methods: The studied subjects were 22 patients of our nursing home (Group A; average age 79.5±5.8 years) and 23 stable outpatients (Group B; average age 73.5±6.4 years) who were undergoing hemodialysis 3 times per week. We evaluated their body weight change, body composition, blood test, dietary intake, grip strength and rate of fracture for one year. Results: In Group A and Group B, their body weight and blood test did not show significantly change. However, after one year, Alb and ChE of Group A were significantly lower (p < 0.05) than Group B. In dietary intake of Group A, their energy intake and protein intake were decreasing greatly. Percentage of grip strength of Group A for grip strength of healthy people was lower (Group A; 68.3%, Group B; 84.5%). Rate of fracture of Group A was higher (Group A; 13.6%, Group B; 3.6%). Conclusion: In this study, all of elderly hemodialysis patients who have lived for one were not found to show the loss of nutrition states and body composition. However, in comparison of Group A and Group B after one year, nutrition states and body composition changed. We thought it is necessary for elderly hemodialysis patients to get support of their family because nutrition states of elderly hemodialysis patients living nursing home are low than outpatients. Furthermore, muscle mass of elderly hemodialysis patients living nursing home reduces greatly, is likely to fracture. Therefore, it is important factor for elderly hemodialysis patients living nursing home to maintain dietary intake and active for maintenance of muscle and appetite. Disclosure of Interest: None Declared
PP168-MON NUTRITIONAL SCREENING, ASSESSMENT AND MALNUTRITION MANAGEMENT CURRENT STATE OF KNOWLEDGE OF MEDICAL STAFF IN ONCOLOGY V. Frick1 , B. Schlegel1 , M. Richter2 , S.C. Bischoff2 , W.G. Zoller1 , P. Clemens3 . 1 Ern¨ ahrungsteam und Klinik f¨ ur Allgemeine Innere Medizin, Gastroenterologie, Hepatologie und Infektiologie, Klinikum Stuttgart, 2 Universit¨ at Hohenheim, Institut f¨ ur Ern¨ ahrungsmedizin, 3 Gastroenterologie und Tumormedizin, St. Anna Klinik Bad Cannstatt, Stuttgart, Germany
Disclosure of Interest: None Declared
Rationale: First aim of this study was to examine the perception of the nutrition support team (NST) and its special tasks by doctors and nursing staff in oncologic departments of the Katharinenhospital Stuttgart, Germany. Second aim was to evaluate knowledge about malnutrition, nutritional screening and malnutrition management. Methods: Single choice and multiple choice questionnaire interview before and after implementation of Nutritional Risk Screening (NRS) and malnutrition training.
PP166-MON AN AUDIT OF THE DIETETIC MANAGEMENT OF REFEEDING SYNDROME IN A DUBLIN TEACHING HOSPITAL G. Corrigan1 , C. O’ Neill1 , N. Connolly1 , O. Deeney1 , E. Fanning1 , H. Guiden1 , R. Hannon1 , A. Lyons1 , K. McElligott1 , S. McMahon1 , C. Moreau1 , A. Shaw1 . 1 Nutrition & Dietetics, Beaumont Hospital, Dublin, Ireland Rationale: Our enteral feeding audit (2011) highlighted variation in dietetic management of patients at risk of refeeding syndrome (RS). We aimed to investigate this further and improve uniformity of practice. Methods: A questionnaire, based on a similar UK study [1] was completed (2012) by all dietitians (n = 17), including case scenarios to elicit RS risk and recommendations for caloric, micronutrient and electrolyte provision. Results were presented to the department. A medical audit highlighted poor awareness of RS and an interdisciplinary working group was formed. A hospital RS policy was developed and dietetic practice was re-audited in 2013 (n = 15). Results: Substantial variation was seen in perceived risk of RS with 53% of respondents correctly identifying high RS risk as per NICE2 . Extreme and moderate risk were identified in 71% and 64% of respondents respectively. Identification of RS risk improved at all levels on re-audit, with 87%, 80% and 67% of dietitians identifying high, extreme and moderate risk respectively. Recommendations for initial caloric provision improved; 80% correctly prescribing 10 kcal /kg in high risk and 50% giving 5 kcal /kg in extreme risk, compared to 47% and 35% respectively on initial audit. Some overfeeding at extreme risk was still evident on re-audit, while underfeeding in high risk ceased. Recommendations for appropriate route and dose of thiamine and multivitamin supplementation markedly improved (80% vs 24%). Provision of full electrolyte requirements on feed initiation, as per NICE2 was deemed unsafe. Conclusion: Dietetic identification of RS risk, caloric provision and micronutrient recommendations improved at all levels of risk, with some scope for increased uniformity. References [1] G. Wagstaff (2011). Dietetic practice in refeeding syndrome. J Hum Nutr Diet, 24, pp. 505 515. 2. NICE National Institute for Health and Clinical Excellence. Nutr Support in Adults. Clin guideline 32, 2006.
Poster presentations PP167-MON RELATIONSHIP OF NUTRITION STATES AND BODY CONDITION OF ELDERLY HEMODIALYSIS PATIENTS LIVING NURSING HOME M. Yoshiko1 , K. Yukie2 , S. Yuzuru1 . 1 Sato Junkanki Hospital, Matsuyama, Matsuyama-shi, Ehime-ken, 2 Tokyo Healthcare University, Tokyo, Japan Rationale: We investigated nutritional status and body composition in elderly hemodialysis patients who are living in the nursing home. Methods: The studied subjects were 22 patients of our nursing home (Group A; average age 79.5±5.8 years) and 23 stable outpatients (Group B; average age 73.5±6.4 years) who were undergoing hemodialysis 3 times per week. We evaluated their body weight change, body composition, blood test, dietary intake, grip strength and rate of fracture for one year. Results: In Group A and Group B, their body weight and blood test did not show significantly change. However, after one year, Alb and ChE of Group A were significantly lower (p < 0.05) than Group B. In dietary intake of Group A, their energy intake and protein intake were decreasing greatly. Percentage of grip strength of Group A for grip strength of healthy people was lower (Group A; 68.3%, Group B; 84.5%). Rate of fracture of Group A was higher (Group A; 13.6%, Group B; 3.6%). Conclusion: In this study, all of elderly hemodialysis patients who have lived for one were not found to show the loss of nutrition states and body composition. However, in comparison of Group A and Group B after one year, nutrition states and body composition changed. We thought it is necessary for elderly hemodialysis patients to get support of their family because nutrition states of elderly hemodialysis patients living nursing home are low than outpatients. Furthermore, muscle mass of elderly hemodialysis patients living nursing home reduces greatly, is likely to fracture. Therefore, it is important factor for elderly hemodialysis patients living nursing home to maintain dietary intake and active for maintenance of muscle and appetite. Disclosure of Interest: None Declared
PP168-MON NUTRITIONAL SCREENING, ASSESSMENT AND MALNUTRITION MANAGEMENT CURRENT STATE OF KNOWLEDGE OF MEDICAL STAFF IN ONCOLOGY V. Frick1 , B. Schlegel1 , M. Richter2 , S.C. Bischoff2 , W.G. Zoller1 , P. Clemens3 . 1 Ern¨ ahrungsteam und Klinik f¨ ur Allgemeine Innere Medizin, Gastroenterologie, Hepatologie und Infektiologie, Klinikum Stuttgart, 2 Universit¨ at Hohenheim, Institut f¨ ur Ern¨ ahrungsmedizin, 3 Gastroenterologie und Tumormedizin, St. Anna Klinik Bad Cannstatt, Stuttgart, Germany
Disclosure of Interest: None Declared
Rationale: First aim of this study was to examine the perception of the nutrition support team (NST) and its special tasks by doctors and nursing staff in oncologic departments of the Katharinenhospital Stuttgart, Germany. Second aim was to evaluate knowledge about malnutrition, nutritional screening and malnutrition management. Methods: Single choice and multiple choice questionnaire interview before and after implementation of Nutritional Risk Screening (NRS) and malnutrition training.