HSE welcomes HIQA's 'Nutrition and Hydration in Hospitals' review

The HSE welcomes the publication by HIQA of the “Report of the Review of Nutrition and Hydration care in Public Acute Hospitals”. The first of its kind, this review uses the National Standards for Safer Better Healthcare to assess how public acute hospitals are ensuring that patient’s nutrition and hydration needs are being adequately assessed, managed and evaluated. Providing patients with good nutrition and hydration care is a fundamental requirement for good care. It underpins the care and treatment of all patients, no matter what their specific clinical problem. Delivering high standards on nutrition and hydration is a priority for all hospitals. It is very encouraging to note the majority of the 579 (86%) patients interviewed by HIQA expressed satisfaction with the meal services they received and confirmed that they received meals suitable to their individual dietary needs.

Many patients expressed surprise to inspectors about the high quality of the food and commented that prior to coming to hospital that they had low expectations of hospital food. Patients were very complimentary about staff and gave inspectors many examples of where staff had been friendly, helpful or went out of their way to accommodate their needs. Seventy eight per cent of the comments made to inspectors on the 13 sites were positive about the food and meals served. Fourteen of the 42 hospitals received compliments in relation to nutrition and hydration. One hospital had 58 recorded compliments.

The report also notes that most staff with whom inspectors spoke welcomed HIQA’s focus on nutrition and hydration and were enthusiastic about introducing improvements for patients. Many hospitals demonstrated a genuine commitment and enthusiasm to promoting and leading improvements in nutritional and hydration care for patients. While much work has already been done in our hospitals to improve patient hydration and nutritional needs, the HSE remains fully committed to addressing the reports four key areas for further improvement. These are:

1. All hospitals should have a nutrition steering committee in place to implement systems to ensure that all patients admitted to hospital receive high quality nutrition and hydration care. Thirty of the 42 hospitals reported that they had a nutritional steering committee in place.

2. All patients admitted to hospital should be screened for the risk of malnutrition. Twenty one of the 42 hospitals stated they had implemented screening in all wards. Improvement plans are being developed and screening will be implemented on a phased basis.

3. Hospitals must audit compliance with all aspects of patients’ nutritional care and share the findings with all relevant staff groups involved in food service and patient care. Standardised auditing tools will be shared between hospitals/hospital groups. Hospitals are currently analysing their in-patient hospital menus and a forum for sharing of standardised menus is being developed

4. Hospitals should strive to improve patients’ experience of hospital food and drink by engaging with patients about food variety and choice. Patient satisfaction surveys are used and will be shared and implemented as part of the improvement plans. Quality Initiatives like “protected mealtimes” currently in place in some hospitals will be rolled out

The HSE has identified two strategic priority actions in the National Service Plan for 2016 in relation to improving food and nutrition in hospitals:

• The development of a hospital food and nutrition policy, to be accompanied by an implementation plan

• A quality improvement programme in relation to nutrition and hydration which will be delivered across services, including acute hospital services

Last updated on: 27 / 05 / 2016