Standard of hospital food leaves patients at risk of malnutrition - report
The standard of hospital food and a failure to even provide regular drinking water leaves many patients at serious risk of malnutrition and dehydration, a damning report revealed today.
The highly-critical review comes in the first independent inspection of hospital nutrition by the Health Information and Quality Authority.
It said malnutrition affects more than one in four patients admitted to hospital.
Despite this, 21pc of public acute hospitals “don’t have a system of screening in place for the risk of malnutrition.
“The annual healthcare costs associated with disease-related malnutrition were estimated at €1.5 billion in a 2012 study.”
Susan Cliffe, HIQA’s Head of Healthcare, warned: “Food should be seen as an integral part of a patient’s treatment, rather than a ‘hotel service’ provided by the hospital.
“Many patients experience unintentional weight loss of over 10% of their body weight prior to admission and their nutritional status often deteriorates while in hospital. Nutrition and hydration is fundamental to their treatment and recovery plan of care.
“It is recognised internationally that malnutrition and dehydration can compromise the quality of life of patients, affect their recovery and cause unnecessary illness and death.
“ In patients at risk, it can go undetected unless systems are in place to identify and manage it.”
The watchdog examined 42 hospitals, carried out unannounced inspections in 13 of these hospitals, spoke with 579 patients and 363 staff, and reviewed 322 patient healthcare records.
While many hospitals demonstrated a commitment to promoting and leading improvements in nutrition and hydration, there was a wide variation in findings.
Ms Cliffe said: “Every patient should be screened for risk of malnutrition within 24 hours of admission to hospital.
“Our review shows that only half of the 42 hospitals are doing this on more than 75pc of wards. One in five hospitals has no system of screening for risk of malnutrition in any area of the hospital.
“ Hospitals who have not introduced such screening to date must now proceed, without delay, to implement a system to ensure that all patients are screened for the risk of malnutrition on admission to hospital in line with evidence-based practice”.
She said offering and providing drinking water for patients is a basic care requirement. However, HIQA found examples of where the hydration needs of individual patients were not being met.
This mainly applied to patients in emergency departments who were deemed to be admitted, but who remained there for lengthy periods while waiting for a bed in the main hospital.
While all 42 hospitals had stated in advance of inspections that patients had access to fresh drinking water, HIQA inspectors found that drinking water was only topped up by staff during the day in most inspected hospitals if a jug was seen to be empty or at a patient’s request.
In a number of emergency departments, patients who were not mobile and could not access the water cooler were not routinely being offered drinks. In addition there was a lack of consistency in the meals offered to patients in emergency departments.
Less than one in three hospitals inspected had a system to replenish water jugs with fresh water during the afternoon so as to ensure that patients always had access to fresh water.
Access to drinking water should not depend on relatives and visitors and hospitals must ensure that all patients have access to fresh drinking water as required.
She added: “Hospitals need to improve governance of nutrition and hydration to support improvements in screening patients for risk of malnutrition, develop evidence-based policies and audit nutrition and hydration care. Hospitals should strive to improve patients’ experience of hospital food and drink by engaging with patients about food variety and choice. A key feature of this process is the evaluation of patients’ experience of nutritional and hydration care and using patients views to inform and direct change or to reinforce good practices where they exist.”