national-clinical-guidelines-for-stroke-fourth-edition

Nutrition and dietetics concise guide for stroke 2012
Nutrition and dietetics concise guide for
stroke 2012
These profession-specific concise guidelines contain recommendations extracted from the National
clinical guideline for stroke, 4th edition, which contains over 300 recommendations covering almost every
aspect of stroke management. The recommendations for each profession are given with their numbers,
so that they can be found in the main guideline.
The recommendations below have direct implications for dietitians. These should not be read in isolation
and as members of the stroke multidisciplinary team, dietitians should consider the guideline in full.
Structure – global cover (2.1.1)
C Commissioners need to be satisfied that all
those caring for stroke patients have the
required knowledge and skills to provide safe
care for those with restricted mobility, sensory
loss, impaired communication and
neuropsychological impairments.
Commissioning secondary prevention
services (2.3.1)
B Commissioners should commission acute
hospital health services to:
● identify and initiate treatment for all
treatable risk factors as soon as possible
● give all patients written information and
advice on lifestyle changes that reduce the
risk of stroke, tailored to the needs of the
individual person
● liaise with general practitioners about the
long-term management of any identified
risk factors for each patient.
C Commissioners should facilitate the lifestyle
recommendations made through:
● supporting smoking cessation
● working with other organisations to make it
easier for people with disability to
participate in exercise
● supporting healthy eating
● supporting those with an alcohol problem
to abstain or maintain their intake within
recommended limits.
Specialist stroke services (3.2.1)
E Patients with acute stroke should have their
swallowing screened, using a validated
screening tool, by a specially trained healthcare
professional within 4 hours of admission to
hospital, before being given any oral food, fluid
or medication, and they should have an
ongoing management plan for the provision of
adequate nutrition.
Resources (3.3.1)
B Each stroke rehabilitation unit and service
should be organised as a single team of staff
with specialist knowledge and experience of
stroke and neurological rehabilitation including:
● dietitians.
Transfers of care – discharge from hospital
(3.8.1)
B Hospital services should have a protocol,
locally negotiated, to ensure that before
discharge occurs:
● patients and carers are prepared, and have
been fully involved in planning discharge
● general practitioners, primary healthcare
teams and social services departments
(adult services) are all informed before, or
at the time of, discharge
● all equipment and support services
necessary for a safe discharge are in place
140 © Royal College of Physicians 2012