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Improving nutritional standards for children has become a national health initiative. However, children who are hospitalized are
often at additional risk for poor nutrition and diet. Additionally, patients who suffer from psychiatric illness are more vulnerable
to weight gain while hospitalized. When the change was made from individual patient trays to family style, buffet style dining,
nursing staff on the Child and Adolescent Psychiatry Unit of the Johns Hopkins Hospital noted significant patient weight changes.
Initial menu selection was developed to include patient favorites like chicken tenders, macaroni and cheese, donuts and bacon.
Unfortunately, these foods were also high in sugar, fat and salt. A quality improvement project was initiated to address this issue and
promote healthy weight maintenance. Nursing staff requested changes to the types of foods served and placed limits on how much
patients were permitted to eat. When the menu was overhauled, it limited those unhealthy foods and also offered a sandwich and
salad bar daily. In addition, a nutrition group was developed in order to educate the patients regarding healthy food choices. Weight
changes were able to be reduced from a mean change of 2.5 kilograms to a mean change of 0.01 kilograms. Patient education, healthy
food choices and limiting the amount of food eaten at meals had positive outcomes on patient weights while hospitalized on a child
and adolescent psychiatry unit.
Nancy A Praglowski, MS, RN, is the Nurse Manager of the Child and Adolescent Psychiatry Unit of the Johns Hopkins Hospital in Baltimore, Maryland. She received her BSN from the University of Pittsburgh in 1989 and her MS in Nursing Administration from Stevenson University in 2014. She has been working in child psychiatry for 26 years.