Background: Insufficient Nutritional support is associated with prolonged hospitalisation, impaired wound healing and impaired survival for patients in intensive care. In severe sepsis and septic chock, calculation of nutritional need is complicated since the metabolism is affected by decease. Aim: The aim of the study was to investigate Nutritional support and to examine the quality of nursing documentation of nutritional status and Nutritional support in patient records in severe sepsis and septic chock.  Method: The study was conducted as a retrospective investigation where 64 patient records were studied. The quality of documentation was examined in 10 patient records using an examinational model.Findings: Calculation of average Nutritional support showed insufficient supply particularly in the two first days of intensive care. During the next five days nutritional supply was higher but individual variation was seen, why a clear picture of Nutritional support is hard to detect.

The aim of the literature review was to illuminate the importance of nutritional management to patients who have sustained a traumatic brain injury (TBI) and describe nurses responsibility and meaningful function in the Nutritional support. TBI patients tend to be associated with hypermetabolism and hypercatabolism, resulting in negative nitrogen balances. The results reveal increased energy expenditure and assessments of needs energy requirements at the TBI patients. This study determining the route of feeding: enteral versus parenteral nutrition. Furthermore describes complications associated with enteral feeding.

Introduction: Balance between the essential nutritive substances is important for aperson to maintain health. The surgical patient can be stricken with conditions, whichhave a negative impact on this balance and can lead to malnutrition. Working as a nurseit is important to identify patients that are malnourished or is in the risk zone ofmalnourishment since 30 % of all patients in hospitals are malnourished.Aim: The aim of this study was to examine the compliance to the guidelines fornutritional assessment and parenteral nutrition on a surgical ward. Also whether thenutritional treatment/-support was reported to the next caregivers if the patient wasmalnourished or was in the risk zone of malnourishment at the time of discharge.Method: 80 patients enrolled on the ward in the beginning of year 2011 were included.Audit of patient records was made according to the hospital guidelines for nutrition andparenteral nutrition and followed a study specific protocol.Results: The examination of the case records showed that the guidelines for nutritionwere partly complied with. Nutritional treatment/-support was reported to the nextcaregivers when needed.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionTitle: Can Nutritional support contribute to the healing of pressure ulcers in elderly patients?Author: Anton Kinnander, Sandra SmidelikSupervisor: Elisabet RothenbergExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: 12-04-11Background The number of elderly patients with co-morbidity is increasing in the western world. It is therefore reasonable to predict increasing incidence and prevalence of pressure ulcers. One study, published 2009, found that as many as 59 % of geriatric patients within the Swedish health care system had developed pressure ulcers. Symptoms vary from mild erythema to severe deep tissue damage and development of pressure varies from hours to weeks.

AimThe study aims were to identify young adults? sources of nutritional advice on the Internet and how they perceive the credibility of these. The study also aimed at exploring young adults' knowledge of national recommendations issued by the National Food Agency.MethodA web-based survey was distributed on the social media platform Facebook. The questionnaire contained a total of 14 questions regarding online nutritional advice and its credibility. Finally, it requested the respondent's knowledge and credibility of the national nutritional recommendations.

Undernäring förekommer både inom sjukvård och inom omsorg. Det är sjuksköterskans uppgift att identifiera näringstillstånd och det kan göras genom antropometriska mått och bedömningsinstrumentet Mini Nutritional Assessment (MNA). Syftet med litteraturstudien var att belysa sjuksköterskans nytta av bedömningsinstrument MNA. Resultatet baserades på 15 artiklar. Det är vanligt inom omvårdnad att personer är undernärda eller är i riskzonen för att drabbas av undernäring.

Sahlgrenska Academy at University of GothenburgDepartment of Clinical NutritionAbstractTitle: The effect of nutritional treatment on functional recovery after stroke, a systematic reviewAuthor: Ingrid Blankenau and Amanda LindbladSupervisor: AnneMarie GrönbergExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTS Type of paper: Examination paper, 15 hpDate: April 13, 2011Background: Every year 30 000 people in Sweden suffer from stroke. This costs society about twelve billion SEK. Many stroke survivors experience functional impairment which may lead to difficulties for them to meet their nutritional needs. Nutritional treatment is important in the recovery process after stroke as malnutrition increases the risk of complications.Objective: To investigate the possible effect of nutritional treatment on functional recovery after stroke.Search strategy: The search was conducted in the databases PubMed, Scopus and Cochrane by using the English keywords stroke, nutrition, rehabilitation, functional outcome, recovery, acute stroke, ischemic stroke, ischemic acute stroke, nutrition therapy, brain hemorrhage, functional recovery and nutritional rehabilitation.Selection criteria: Studies published before 2001 conducted on human subjects who suffer from stroke where they measured functional capacity and did a nutritional intervention, written in English, Swedish or Norwegian, and did not have to be requested from the library.Data collection and analysis: A systematic search was performed in PubMed. Studies which had an interesting heading were examined and abstract read.

Purpose: The purpose of this interview study was to describe the nurses? view of their experiences of interaction with other professionals to improve the elderly patient's nutritional status in municipal elderly care.Method: The study is based on qualitative interviews with nine nurses and was analyzed according to a qualitative content analysis method.Results: The main themes that emerged: Communication among the involved, To feel secure in their role, Lack of structure. The nurses worked closely with nursing staff and cooperated more with doctors about nutrition than with the physiotherapist and occupational therapist. The nurses felt they had the main responsibility for maintaining a good nutritional status of the elderly patient and described themselves as primarily responsible for nutrition while they lacked nutritional competence equal to the responsibilities they had during the whole nutrition process. The nurses had no community dietitian?s skills and felt that the dietitian had a great responsibility and the most updated knowledge in diet and nutrition.

Bakgrund: Undernäring är ett vanligt förekommande problem bland den äldre befolkningen. Att kunna identifiera de människor som lider av undernäring ligger inom sjuksköterskans omvårdnadsansvar. Mini Nutritional Assessment (MNA) skalan är ett av de olika mätinstrument som används för att i tidigt skede upptäcka undernärda äldre eller de som riskerar att bli undernärda. Syfte: Att beskriva sjuksköterskans erfarenheter av användning av MNA-skalan hos äldre patienter. Metod: Semistrukturerade intervjuer med hjälp av en intervjuguide genomfördes med tio yrkesverksamma sjuksköterskor på två geriatriska avdelningar.

ABSTRACTIn an intermediate section at a large university hospital are patients with subarachnoid hemorrhage (SAH) cared for. There are international, national and local guidelines how nutrition therapy should be implemented and how much energy each patient should be given when hospitalized. The purpose of this study was to examine the documentation and actions on nutrition in patients with SAH and to see if guidelines on nutrition were followed. The study was a quantitative, retrospective record review that was analyzed statistically and descriptive. 26 patients were included.

Background: The Swedish population is aging [1] and malnutrition is a common problem among elderly people [2]. A method called food registration is used to monitor the patients? nutritional intake, with the purpose of reducing the risk of patients deteriorating in nutritional status during hospitalisation. However, the current method is not satisfactory and many food registration lists are incomplete. [3-6] Thus, patients do not receive a qualitative nutritional care since the assessment of the patients? nutritional status is based on incomplete documentation.Purpose: The purpose of this master thesis is to increase the quality in the nutrition monitoring process in the geriatric units B72 and B74 at Karolinska University Hospital in Huddinge, Sweden.

I have investigated how municipalities support children with ADHD. I have interviewed persons responsible in five different municipalities. The persons have had the authority to decide how the support funds are to be shared in the municipality. Mostly I was interested to know if the support was the same in all these municipalities and if the children with ADHD really got the help and support they were entitled to. I discovered that the support varied; in some the children were correctly diagnosed but in others municipalities I was not convince.

Background: The Swedish population is aging [1] and malnutrition is a common problem among elderly people [2]. A method called food registration is used to monitor the patients? nutritional intake, with the purpose of reducing the risk of patients deteriorating in nutritional status during hospitalisation. However, the current method is not satisfactory and many food registration lists are incomplete. [3-6] Thus, patients do not receive a qualitative nutritional care since the assessment of the patients? nutritional status is based on incomplete documentation.Purpose: The purpose of this master thesis is to increase the quality in the nutrition monitoring process in the geriatric units B72 and B74 at Karolinska University Hospital in Huddinge, Sweden.

Bakgrund: Adekvat näringstillförsel är en viktig del i återhämtning och utfall förintensivvårdspatienter. Nutrition på IVA har visats sig ha en lägre prioritet jämförtmed övriga omvårdnadsåtgärder. Internationella studier har därtill belyst attintensivvårdspatienter ofta erhåller otillräcklig näringstillförsel, vilket är förknippatmed negativa följder för patienten. Syfte: Syftet med studien var att undersöka hurmycket näring intensivvårdspatienter erhåller, utifrån beräknat näringsbehov baseratpå 25 kcal/kg/dygn. Metod: En retrospektiv datajournalgranskning utfördes påpatienter som hade en vårdtid längre än sju vårddygn, oberoende av ålder, kön ochdiagnos.

When a family member is being cared for in palliative care relatives often need support to be able to support their family member. The purpose of the literature review was to illuminate the nursing staff?s support from the relatives? perspective when a family member is being cared in a late palliative phase. The study is a literature review, there already existing research are surveyed. The findings were structured into two parts, tangible- and the intangible support.