Das Tellerdiagramm: Ein sinnvolles Erfassungsinstrument für ungenügende Nahrungszufuhr bei Patienten im Krankenhaus

Aktuelle Ernährungsmedizin. 2006; 31(2): 66-72. doi: 10.1055/s-2006-932568.
Rüfenacht, U., Rühlin, M., Imoberdorf, R., Ballmer, P.E.


Purpose: A substantial number of hospital patients does not cover the daily nutritional needs. However, the deficiency in intake often is not recognized in the hospital. Therefore, we have developed an easy tool to record nutritional intake. Our plate diagram („Tellerdiagramm”) is integrated in the patients' documentation. The amount of each meal which was consumed, is filled in the diagram with a precision of a quarter of a plate. In the present study, we have validated the plate diagram in the clinical setting.
Methods: We have randomly chosen 29 meals. The meals were weighed before and after the patient had eaten and the effectively consumed quantity of the serving was calculated by substraction. Then, the amount of the meal consumed was compared with what the nursing staff had filled in the plate diagram.
Results: The correlation between the plate diagram and the effectively consumed energy and main nutrients was weak in the individual case. However, the amount of protein consumed was significantly given by the Plate Diagram (linear regression, p < 0.001). Moreover, patients with diagrams blanked out less than 50 % over a few days, had a clearly insufficient food intake. We also elaborated guidelines for the use of the diagram to aim a uniform handling.
Conclusions: Our plate diagram is a useful instrument to detect insufficient food intake. The diagram reflects the course of food intake and helps to identify early problems with intake. We suggest that the standardized documentation of food intake should be as important as recording the excretions. We observed that doctors and nurses gained substantial awareness by the use of the diagram in regard to nutritional problems and food intake.

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List of abbreviations

DGEM German Society for Nutritional Medicine (German Deutsche Gesellschaft für Ernährungsmedizin)
GESKES  Swiss Society for Clinical Nutrition (German Gesellschaft für klinische Ernährung der Schweiz) 
ESPEN European Society of Clinicl Nutrition and Metabolism