NAC449.339. Dietary services: Nutritional status of patients.

     1. A hospital shall carry out a program for the systematic nutritional risk-screening of its patients to detect actual and potential malnutrition at an early stage.

     2. A hospital shall ensure that each patient maintains acceptable parameters of nutritional status, including, without limitation, body weight and protein levels, unless the patient’s clinical condition demonstrates that the maintenance of those parameters is not possible.

     3. A patient who is fed by an enteral feeding system must receive the appropriate treatment and services to prevent complications to the extent possible.

     4. Parenteral nutrition support must be used to nourish a patient who meets clinical guidelines that are developed in accordance with nationally recognized standards of practice and approved by the medical staff of the hospital.

     5. A patient must receive a therapeutic diet when it is determined that he or she has a nutritional problem.

     6. The director of the dietary service shall develop and carry out policies and procedures for nutritional care and dietetic services. The policies and procedures must be readily available to nursing, dietary and medical staff. The director shall evaluate the policies and procedures for nutritional care and services provided by the dietary service on a regular basis and revise those policies and procedures as necessary.

     7. If it is determined that the nutritional status of a patient is at risk, nutritional care for that patient must be:

     (a) Planned and provided based on an assessment of his or her nutritional status by a licensed dietitian or the attending physician, or both; and

     (b) Integrated into his or her plan of care.

Ê The response of the patient must be monitored and reassessed as needed.

     8. Pertinent dietary information must be included in a patient’s transfer records or discharge records, or both, to ensure continuity of nutritional care.

     (Added to NAC by Bd. of Health by R050-99, eff. 9-27-99; A by R090-12, 12-20-2012)