Dietary Management of Atherosclerosis

Food delivery in a Hospital or Nursing home

You should have an idea how things work getting food from the hospital or nursing home kitchen to the patient’s room. So, here is a brief review.

Who orders the food at the hospital?

The person in the hospital or nursing home ordering the hospital food is either the foodservice director or their assistant and food orders are based on current and projected census.

Who orders the diet?

Either the MD or the nurse order the patient diet. Once the diet is ordered the clerk on the floor, nurse or nurse’s aide would make certain the diet is received by the diet office. In Illinois: If the RDN has clinical privileges the RDN can order diet orders and supplements in the hospital setting. However, in long term care an MD is the only person who can do this.

Who in the kitchen would make certain the patients diet order is recorded and that they are placed on a diet?

The diet clerk verifies the patients and then makes a note of it so they are sent the correct menu.

Who would go up to the patient floor to get food preferences from a patient?

Usually the dietetic technician would do this but it could also be the RDN.

Who would screen the patient and assess their nutrition risk status?

The nurse who admits the patient will ask them some standard screening questions (each question gives you a certain score) and that score is entered into the system. Moderate and high-risk patients would be flagged (based on their screening score) so the RDN know they need to see that patient.

Who would give the recommendation to do a calorie count or to start an enteral tube feeding?

This would be the role of a dietetic technician or RDN. Sometime an RN or MD would order a nutrition consult to assess intake of the patient and this would lead to the diet tech or RDN starting a calorie count. Once the calorie count is kept the RDN adds up calories and protein intake and determines the best plan of action. If the patient cannot meet their calorie or protein needs with food and supplements, then the RDN will assess patient for a tube feeding.