THERAPEUTIC DIETS PROTOCOL –PRI & MRH

INTRODUCTION

Reference A, below; requires there to be a protocol in place for the provision of therapeutic diets, throughout NHS Tayside.

As part of NHS Quality Improvement Scotland’s Clinical Standards for Food, Fluid and Nutritional Care in Hospitals, there has to be a protocol to explain the provision of therapeutic diets.

This protocol contains the procedures to be taken to ensure patients receive the correct food for their dietary needs.

On admission to hospital all patients should be assessed by nursing staff within 24 hours of admission to see if they have specific dietary needs, e.g. therapeutic, food allergies & cultural/ethnic diets.

THERAPUTIC DIETS

Therapeutic & special diets will be catered for by the Catering Department. This may require an adaptation of the selected menu item (on the patient menu – White Card). It is the responsibility of the ward to submit menus which are appropriately identified & with adequate choice selected. (examples of menus to be adapted are gluten free, dairy free, low sodium etc).

Nursing Staff should ensure each patient’s menu card is checked for suitability of food choice and offer assistance in the choice if required. Patients requiring a texture modified diet should complete the Texture Modified Menu Card (Pink Menu Card) with the assistance of Nursing Staff if required.

Vegetarian dishes are included in the main menu, however, should the patient dislike that menu choice, they may choose from the Vegetarian Menu retained at ward level.

If there is a requirement for Ethnic Meals, the patient should choose from the Ethnic Menu held at ward level. If you have any problems or concerns, please contact the Catering Office on Ext. 13213 and ask to speak with the Senior Supervisor or Catering Manager.

Clear fluid diets are found on the Blue Menu Card & are available at ward level for patients requiring any bowel preparation prior to a procedure eg. Barium enema.

Most patients will be admitted through the Admissions Ward, Ward 4. Transitional feeding arrangements for Ward 4 differ from the rest of the hospital. The transfer of patients between wards will be effective for one meal only, after which the discharging ward must submit a completed Menu Cancellation Slip and the admitting ward a completed menu.

Information on patients discharged from a ward or hospital, should be entered on a Menu Cancellation Slip and placed in the Menu Post Box located outside the Catering Managers Office or taken to the Catering Office. Telephone messages should be restricted to emergency situations and be effective for one meal only. Please do not use the telephone as a matter of course.

The following are example therapeutic diets: -

  • Texture Modified meals as per NHST descriptors for Texture’s B, C, D and E
  • MAOI (Low tyramine) diets
  • Reduced Lactose/ Lactose Free
  • Food allergies & intolerences
  • Milk / Dairy / Egg free
  • Gluten Free

Ward staff should contact the dietician if the patient is at nutritional risk.

Within the daily patients menus there is a selection of foods that can be safely used as a Soft Option(however if the Texture Modified Menus should be used for all patients requiring texture modification – Pink Menu Cards).

Daily requirements for these diets are written on the individual patients meal-ordering sheet, (transferred to a special dietary sheet within the catering department & passed onto the Diet Kitchen)prominently marked by ward staff to identify the allergy.

If it is known in advance that a patient coming into hospital has a special catering requirement inform your kitchen as early as possible so items suitable for the diet can be obtained.

Whilst the diets listed above is not an exhaustive list; these are the main diets provided in P&K. The catering department should be contacted as soon as possible for diets required but not listed above, so they can accommodate these requirements.

CONTACT NUMBERS

The contact numbers for the catering departments, Dieticians & Speech and Language Therapists are listed below;

PRI Catering Department

/

Internal Extension

/

Direct Dial Number

Catering Office / 13211 / 01738 473211
Senior Supervisor / 13213 / 01738 473213
Kitchen
(out with office hours) / 13539 / 01738 473539
Diet Kitchen / 13613 / 01738 473613
Catering Services Manager / 13218 / 01738 473218

Dietician

/

Internal Extension

/

Direct Dial Number

Dietitians PRI / 13215 / 01738 473515
Dietitians MRH / 62279 / 01738 562279

Speech & Language Therapist

/

Internal Extension

/

Direct Dial Number

Secretary / 13714 / 01738473714

Appendix 1 NORMAL / THERAPEUTIC / OTHER DIET PROCEDURE CHART

Appendix 2

CAT
/
DIET TYPE
/ WARD STAFF
INPUT
/ DIET AUTHORIZED BY / PROVIDED BY CATERING DEPT /
COMMENTS
SALT / DIETICIAN
TH
/ Texture Modified / * / * / * / * / As per NHST descriptors B,C, D and E
TH / MAOI / * / *
TH / Low Fat /Fat Free / * / *
TH / Reduced Lactose / Lactose Free / * / *
TH / Dairy / Milk / Eggs / * / *
AL / Shell Fish / * / *
AL / Dairy, Milk, Eggs / * / *
AL / Nuts / Seeds / * / *
AL / Gluten / Wheat / * / * / Wards to order bread, biscuits, Crackers & cake from the diet kitchen
OND / Healthy Eating / * / *
OND / Vegetarians / Vegan / * / * / Vegetarian menu held at ward level in MUST folder
OND / Ethnic, Religious & Cultural / * / * / Halal menu held at ward level in MUST folder in several languages

PRI & MRH DIET MATRIX

TH = Therapeutic Diet / AL = Allergens / OND = Other Named Diets

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Copyright © 2012. Catering Department, NHS Tayside. This publication can be used or reproduced including photocopying, for non-commercial purposes. We request that the source and Copyright owners be acknowledged and that the material is not substantially altered in any way. Applications for use outwith these terms should be forwarded in writing to the Catering Department, NHS Tayside.