By: Sanele Nkomani, MS, RD
Supervising Dietitian, Feed the Future Innovation Lab for Nutrition
In late November 2018, the Feed the Future Innovation Lab for Nutrition hosted two successful trainings on advanced nutrition support for dietetic students, registered dietitians, critical care nurses, and doctors working at the two major tertiary hospitals in Malawi — Kamuzu Central Hospital in Lilongwe and Queens Central Hospital in Blantyre. There were also doctors and dietitians from private hospitals in attendance, including Baylor Children’s Hospital and Blantyre Adventist Hospital.
The two-day trainings, taught by a staff dietitian from Fresenius Kabi South Africa, were held at the College of Medicine, Lilongwe Campus and at the College of Medicine, Blantyre Campus. Fresenius Kabi South Africa is involved in providing healthcare practitioners with medicines, IV fluids, nutritional solutions, and administration devices to meet the needs of both acutely and chronically ill patients. (fresenius-kabi.com)
The aim of these trainings was to enable the attendees to increase their knowledge of all aspects of nutrition support. In addition, the trainings were designed to promote evidence-based practice in assessing, intervening, monitoring and evaluating patients on enteral and parenteral nutrition.
The trainings covered an in-depth study of the rationale for nutrition support, nutrient requirements in various disease states, implementation of enteral and parenteral nutrition support, and the management of complications related to administering nutrition support.
Training attendees provided positive feedback on the content and delivery of the training to the Nutrition Innovation Lab staff. Many of the participants acknowledged they had a knowledge gap around the topic of nutrition support.
One nurse commented, “I come out of this training with a full understanding of what the consequences of under-feeding critically ill patients are, and what practices may be contributing to underfeeding in my unit. We urgently need dietitians to work with us on improving feeding practices.”
Another remark from a student dietitian was, “This training has given me more hands-on, practical experience of what we have been learning in class on enteral and parenteral nutrition."
Most notably, hosting these trainings has allowed us, the Tufts University, Nutrition Innovation Lab staff to see the impact the dietetic program has had through the work of its graduates and the donation of enteral nutrition supplies to Queen Elizabeth Central Hospital in Blantyre. The doctors spoke highly of the feeds that we had donated to the pediatric and surgery departments. They shared how they are successfully using enteral nutrition for post-surgical and burn patients. The doctors also commented that they are observing fewer complications with the use of ready to hang enteral nutrition compared to the blenderized feeds previously used. This is the first time that such evidence-based nutrition interventions have been used in a public Malawian hospital. There is a clear shift in knowledge and appreciation of clinical nutrition amongst medical staff, which can also be attributed to the presence of one of our graduate dietitians at Queen Elizabeth Central Hospital.
Support for this effort was provided by the Feed the Future Innovation Lab for Nutrition which is funded by the United States Agency for International Development (USAID).