Royal College of Physicians Intercollegiate Stroke Working Party Evidence-Based Guidelines for the Nutritional Support of Patients Who Have Had a Stroke
Journal of Human Nutrition and Dietetics
Gomes, F., Hookway, C., et al. (2013).
Journal of Human Nutrition and Dietetics, 27(2), 107-121.
This guideline provides recommendations for the management of individuals who have had a stroke and are at risk for malnutrition. The included recommendations were developed in preparation for the 4th Edition of the Royal College of Physicians Intercollegiate Stroke Working Party and include relevant recommendations from the National Institute for Health and Care Excellence guidelines on nutritional support for adults (2006).
Royal College of Physicians Intercollegiate Stroke Working Party (United Kingdom)
"People who present with any obvious or less obvious indicators of dysphagia should be referred to healthcare professionals with relevant skills and training in the diagnosis, assessment and management of swallowing disorders" (Good Practice Point; p. 113).
<p>Individuals with suspected dysphagia should:</p>
<ul>
<li>receive a comprehensive swallowing assessment by a dysphagia specialist (Good Practice Point);</li>
<li>receive advice about swallowing precautions and monitored as needed (Good Practice Point);</li>
<li>be considered for alternative fluids (Good Practice Point);</li>
<li>be considered for modified oral nutritional support and/or enteral tube feeding within 24 hours of admission, considering the risks and benefits of these approaches and other patient factors such as level of alertness, vulnerability, and dependence on others for feeding (Good Practice Point).</li>
</ul>
<p>Patients who require modified food for fluid consistency should be:</p>
<ul>
<li>prescribed food or liquid texture modifications according to nationally agreed descriptors (Good Practice Point), and</li>
<li>monitored for fluid balance and nutritional intake (Good Practice Point).</li>
</ul>
Patient who require modified food for fluid consistency should be referred for specialist nutritional assessment (Good Practice Point).
