Orthostatic hypotension due to peripheral vasodilatation is common in the first few months of SCI. Patients with SCI also remain at high risk for pneumonia due to decreased cough reflex and poor secretion clearance. Chest physiotherapy and vaccination should be employed to decrease the risk of this complication. Bowel dysfunction is common after SCI and requires medical therapy to prevent complications. Rectal suppositories are the treatment of choice for managing chronic bowel dysfunction after SCI leading to constipation. Pressure ulcers are also common in patients with SCI and require vigilant pre-emptive skincare. Maintenance of adequate nutritional intake and weight is also crucial in preventing this complication. Pain, depression, and anxiety are common after SCI and should be treated accordingly.
,,FB2,, Nutrition Care Of The Older Adult: A Handbook Of Nutrition Throughout The Continuum Of Care.
To develop a content validated set of indicators to evaluate the quality of meals and meal service in residential facilities for elderly. Inadequate food intake is an important risk factor for malnutrition in residential facilities for elderly. Through better meeting the needs and preferences of residents and optimization of meals and meal service, residents' food intake can improve. No indicators were available which could help to guide strategies to improve the quality of meals and meal service. The indicator set was developed according to the Indicator Development Manual of the Dutch Institute for Health Care Improvement (CBO). The working group consisted of three nurse researchers and one expert in gastrology and had expertise in elderly care, malnutrition, indicator development, and food quality. A preliminary list of potential indicators was compiled using the literature and the working group's expertise. Criteria necessary to measure the indicator in practice were developed for each potential indicator. In a double Delphi procedure, the list of potential indicators and respective criteria were analyzed for content validity, using a multidisciplinary expert panel of 11 experts in elderly meal care. A preliminary list of 20 quality indicators, including 45 criteria, was submitted to the expert panel in a double Delphi procedure. After the second Delphi round, 13 indicators and 25 criteria were accepted as having content validity. The content validity index (CVI) ranged from 0.83 to 1. The indicator set consisted of six structural, four result, and three outcome indicators covering the quality domains food, service and choice, as well as nutritional screening. The criteria measure diverse aspects of meal care which are part of the responsibility of kitchen staff and health care professionals. The 'quality of meals and meal service' set of indicators is a resource to map meal quality in residential facilities for elderly. As soon as feasibility tests in practice 2ff7e9595c
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