Unit 43: Prmting Nutritin and Hydratin in Care Settings Unit reference number: F/616/7360 Level: 3 Unit type: Optinal Credit value: 4 Guided learning hurs: 32 Unit summary What individuals eat and drink is vital t their health and wellbeing. Fr ur bdies t functin prperly, it is imprtant that we have a diet that includes all the nutrients required in the right balance. It is als essential that individuals cnsume an apprpriate vlume f fluids each day. Failure t maintain a well-balanced diet and keep hydrated can lead t ill health. Where individuals are receiving any type f care r supprt, it is imprtant that an assessment is made abut their nutritin and hydratin. This shuld include recrding any allergies, likes and dislikes, any specific supprt they need t eat and drink, and whether they can eat nrmally r need sft fd. In this unit, yu will develp knwledge and skills in prmting health and wellbeing thrugh nutritin and hydratin, and by fllwing a plan f care in care settings. Yu will learn abut the principles f nutritin and a balanced diet, including hydratin, and then apply this in a wrkplace situatin. Yu will have pprtunities t develp, practise and demnstrate the skills required when fllwing a plan f care, and when supprting health and wellbeing thrugh the nutritin and hydratin f individuals. Yu will cnsider special dietary requirements and special diets, including their relevance and imprtance in care settings. 1
Learning utcmes and assessment criteria T pass this unit, the learner needs t demnstrate that they can meet all the learning utcmes fr the unit. The assessment criteria utline the requirements the learner is expected t meet t achieve the unit. Learning utcmes 1 Understand what makes up a balanced diet Assessment criteria 1.1 Define the main fd grups 1.2 Explain surces and rle f essential nutrients fr health 1.3 Evaluate the benefits f a balanced diet n health and wellbeing 1.4 Evaluate the impact f pr diet n health and wellbeing 1.5 Explain what adaptatins t a balanced diet may be required fr different grups 2 Understand nutritinal guidelines 2.1 Summarise current natinal nutritinal guidelines fr a balanced diet 2.2 Explain hw t access additinal supprt and infrmatin relating t nutritin and hydratin 3 Be able t prmte nutritin in care settings 4 Be able t prmte hydratin in care settings 3.1 Explain the imprtance f a balanced diet 3.2 Demnstrate hw t plan and prmte an apprpriate balanced diet with an individual that meets their dietary needs 3.3 Evaluate the effectiveness f different ways f prmting healthy eating 4.1 Explain the imprtance f hydratin 4.2 Describe signs f dehydratin 4.3 Explain ways t supprt and prmte hydratin with individuals 4.4 Demnstrate hw t prmte hydratin with an individual that meets their needs 4.5 Evaluate the effectiveness f different ways f supprting and prmting hydratin 2
Learning utcmes 5 Understand hw t prevent malnutritin in care settings 6 Be able t carry ut nutritinal screening in care settings 7 Be able t mnitr and recrd nutritin and hydratin needs with individuals in care settings 8 Understand factrs that affect special dietary requirements in care settings Assessment criteria 5.1 Explain the factrs that may affect nutritinal intake 5.2 Explain the risk factrs that may lead t malnutritin 5.3 Describe the signs f malnutritin 5.4 Explain ways f ensuring fds and drinks have increased nutritinal density thrugh frtificatin 5.5 Discuss the apprpriate use f nutritinal supplements 6.1 Explain the purpse f nutritinal screening 6.2 Carry ut nutritinal screening in line with agreed ways f wrking 6.3 Implement the actins identified by nutritinal screening in line with agreed ways f wrking 6.4 Mnitr, recrd and review the actins taken fllwing nutritinal screening in line with agreed ways f wrking 7.1 Describe the rles and respnsibilities f self and thers in assessing and managing the nutritinal and hydratin needs with individuals 7.2 Explain ways in which nutritin and hydratin can be mnitred 7.3 Mnitr, recrd and review nutritin and hydratin f an individual in accrdance with their care plan 8.1 Explain factrs that may prmte healthy eating in different grups 8.2 Explain factrs that may create barriers t healthy eating fr different grups 8.3 Explain why individuals may have special dietary requirements 8.4 Explain why it is imprtant fr individuals with special dietary requirements t fllw special diets 3
Cntent Learning utcme 1: Understand what makes up a balanced diet The main fd grups and their surces Carbhydrates: Prteins: Fats: Minerals: Vitamins: Water. starches, e.g. ptates, pasta natural and refined sugars dietary fibre, e.g. bran. plant, e.g. tfu, pulses animal, e.g. meat, fish. saturated, e.g. full-fat milk, plyunsaturated, mnunsaturated. calcium, e.g. milk, sya irn, e.g. red meat, egg ylk, green vegetables sdium, e.g. cheese, meat ptassium, e.g. apricts, bananas. A, e.g. carrts, fish, liver ils B cmplex, e.g. cereals, meat, eggs C, e.g. ranges, blackcurrants D, e.g. fish ils, tuna E, e.g. sunflwer seeds, peanut butter K, e.g. kale, spinach. The rle f essential nutrients Tissue grwth and repair. Immunity against infectin. Prductin f energy. Muscle strength. Principles f a balanced diet Healthy diet, based n sund nutritinal principles. High cnsumptin f fruits and vegetables, unprcessed fds. Lw cnsumptin f red meat and fatty fds, salt, pepper, sugar, saturated fats, cffee and ther caffeinated beverages, alchl. Raw fds and whle grains preferable t prcessed r refined fds. Prtein primarily frm fish, dairy prducts, nuts. Plenty f water. 4
Benefits Life expectancy. Physical and mental wellbeing. Disease preventin, e.g. cardivascular, cancer. Impact f pr diet n health and wellbeing Effects n general physical health and weight. Effects n wellbeing. Ptential impacts, e.g. reduced physical and mental perfrmance, fatigue, besity, increased risk f diseases such as cardivascular disease and cancers, decreased immunity, deficiency diseases such as anaemia, rickets, steprsis, tth decay. Adapting balanced diets fr different grups Grups, e.g. lder peple in gd health, different genders, different cultures, peple with health prblems, peple with dementia, peple with disabilities, peple with learning disabilities, peple with specific dietary preferences, vegetarians, vegans. Adaptins: accrding t needs and preferences, e.g. persnal taste, ability/inability t eat withut supprt specific needs substituting fds. Reducing/increasing certain fds. Learning utcme 2: Understand nutritinal guidelines Current natinal guidelines fr a balanced diet Natinal guidelines, e.g. gvernment dietary recmmendatins, the Eatwell Guide (Fd Standards Agency), Eight Tips fr Healthy Eating (NHS). Accessing additinal supprt and infrmatin Additinal supprt, e.g. Fd Standards Agency, Natinal Institute fr Health and Clinical Excellence (NICE), the Department f Health, Public Health England, British Nutritin Fundatin. 5
Learning utcme 3: Be able t prmte nutritin in care settings Individual Smene requiring care r supprt; it will usually mean the persn r peple supprted by the learner. Imprtance f a balanced diet Definitin f balanced diet. Impact n wellbeing, weight, sleep, general health, mental health. Planning a balanced diet Factrs t cnsider, e.g. likes, dislikes, allergies, cultural and religius requirements, specific health needs. Planning, e.g. ne week (breakfast, lunch, evening meal, snacks, liquids). Ensuring balance and variety f diet. Prmting a balanced diet Prmtin, e.g. thrugh planning f care, explanatin as apprpriate, encuragement, presentatin f fd, gd palatability, variety, prviding suitable utensils, trying different appraches. Learning utcme 4: Be able t prmte hydratin in care settings Imprtance f hydratin Rle f water in the bdy, e.g. dilutin and remving txins, kidney functin. Water lss, e.g. excretin, sweating. Water gain, e.g. eating, drinking. Water balance. Signs f dehydratin mderate Dry muth, lips and eyes, headache, tiredness, dizziness, decreased urine utput, muscle weakness. Signs f dehydratin severe Extreme thirst, lss f skin elasticity, liguria, sunken eyes, absence f perspiratin, rapid heartbeat, lw bld pressure. Supprting and prmting hydratin Explaining the benefits f hydratin. Discvering individual s likes and dislikes. Prvisin f fluids at regular intervals. Water naturally ccurring in fds, e.g. in sup, in yghurt. Encuragement. 6
Learning utcme 5: Understand hw t prevent malnutritin in care settings Factrs affecting nutritinal intake Individual preferences and habits. Physical factrs, e.g. lcatin f meal, psitining, ral hygiene. Psychlgical factrs, e.g. depressin, stress, eating disrders, fd phbias. Incme, lifestyle and scial cnventin. Culture and religin. Advertising and fads. Family and peer grup influences. Ethics, mrals and plitical beliefs. Risk factrs fr malnutritin Risk factrs, e.g. age, medical cnditins, effects f medicatin, psychlgical factrs, incme, ral hygiene, individual habits, cgnitive disrders. Signs f malnutritin Weight lss r gain, decreased muscle and tissue mass, decreased mbility and stamina, dry and scaly skin, breathing difficulties, increased risk f chest infectin and respiratry failure, wunds take lnger t heal, slwer immune respnse, difficulty staying warm. Frtificatin Increasing energy and nutrient cntent. Additin f, e.g. milk pwder, evaprated milk, cheese, butter, cream, sugar, syrup, dried fruits, figs, prunes, ptates, branded fd frtificatins. Nutritinal supplements Types: energy prtein vitamins r minerals, e.g. nutritinal supplement drinks, vitamin and mineral additives. Ptential health benefits. Rle in supprting recvery frm illness. Rle in supprting individuals wh are unable t ingest certain fds. 7
Learning utcme 6: Be able t carry ut nutritinal screening in care settings Nutritinal screening Malnutritin Universal Screening Tl (MUST) a five-step screening tl t identify adults wh are malnurished, at risk f malnutritin (under nutritin) r bese. Implement. Mnitr (use relevant measures, bservatins, physical measurements). Recrd and review actins. Agreed ways f wrking Includes plicies and prcedures where they exist. Referencing t and updating individual s care plan where apprpriate. Learning utcme 7: Be able t mnitr and recrd nutritin and hydratin needs with individuals in care settings Rles and respnsibilities f thers Others, e.g. carers, clleagues, ther prfessinals such as district nurses, GPs, dieticians. Mnitring nutritin and hydratin Using care plan. Recrding preferences. Planning daily intake. Recrding intake. Mnitring t ensure balance. 8
Learning utcme 8: Understand factrs that affect special dietary requirements in care settings Factrs that may prmte healthy eating in different grups Psitive rle mdels, eating with thers, lcatin, educatin, eating supprt/aids. Factrs that create barriers t healthy eating Physical factrs e.g. dysphagia, eating, drinking r swallwing prblems, medical cnditins, psychlgical factrs, lack f understanding, lw incme. Reasns fr special dietary requirements Chrnic disrders, e.g. Celiac disease, Crhn s disease, type 2 diabetes. Allergies including lactse intlerance, gluten intlerance. Scial/cultural. Imprtance f adherence t special diets Meeting requirements. Prmting persnal chice and cntrl. Wrsening f symptms. Ptential life-threatening risks f nt fllwing special diet. 9
Infrmatin fr tutrs Suggested resurces Bks Aldwrth C Nutritin and Well-being (Knwledge Set) (Heinemann, 2008) ISBN 13 9780435402389 Field, Linda Nutritin and Hydratin (Nursing and Health Survival Guides) (Rutledge, 2010) ISBN 13 9780273728719 Fd Standards Agency Manual f Nutritin Reference Bk 342, 11th Editin (Statinery Office, 2008) ISBN 13 9780112431169 Websites www.diabetes.c.uk www.gv.uk/gvernment/publicatins/t he-eatwell-guide www.nhs.uk/cnditins/obesity/pages/ Treatment.aspx www.bhf.rg.uk/hearthealth/preventing-heartdisease/healthy-eating www.cancerresearchuk.rg/abutcancer/causes-f-cancer/diet-andcancer www.nhs.uk/livewell/healthyeating/pages/healthyeating.aspx www.nice.rg.uk/guidance/lifestyleand-wellbeing/diet--nutritin-andbesity www.nice.rg.uk/guidance/cg32 www.nursingtimes.net www.nutritin.rg.uk www.skillsfrcare.rg.uk British Heart Fundatin infrmatin n preventing heart disease thrugh healthy eating. Cancer Research UK infrmatin n diet and cancer. Advice and guidance n nutritin linked t diabetes. Gvernment dietary guidance. NHS Chices advice and guidance n balanced diets and healthy eating. NHS Chices advice and guidance n besity. Natinal Institute fr Health and Care Excellence advice and guidance n nutritin. Natinal Institute fr Health and Care Excellence advice and guidance n nutritinal screening, mnitring and supprt. Nursing Times range f current articles n nutritin and adult care. British Nutritin Fundatin The Care Certificate Standard 8: Fluids and Nutritin. 10
Assessment This guidance shuld be read in cnjunctin with the assciated qualificatin specificatin fr this unit. This unit is internally assessed. T pass this unit, the evidence that the learner presents fr assessment must demnstrate that they have met the required standard specified in the learning utcmes and assessment criteria, and the requirements f the assessment strategy. T ensure that the assessment tasks and activities enable learners t prduce valid, sufficient, authentic and apprpriate evidence that meets the assessment criteria, centres shuld fllw the guidance given in Sectin 8 Assessment f the assciated qualificatin specificatin and meet the requirements frm the assessment strategy given belw. Wherever pssible, centres shuld adpt an hlistic apprach t assessing the units in the qualificatin. This gives the assessment prcess greater rigur and minimises repetitin, time and the burden f assessment n all parties invlved in the prcess. Unit assessment requirements This unit must be assessed in accrdance with the assessment strategy (principles) in Annexe A f the assciated qualificatin specificatin. Assessment decisins fr learning utcmes 3, 4, 6 and 7 (cmpetence) must be made based n evidence generated during the learner s nrmal wrk activity. Any knwledge evidence integral t these learning utcmes may be generated utside f the wrk envirnment, but the final assessment decisin must be within the real wrk envirnment. Simulatin cannt be used as an assessment methd fr learning utcmes 3, 4, 6 and 7. Assessment f learning utcmes 1, 2, 5 and 8 (knwledge) may take place in r utside f a real wrk envirnment. 11