The Health Information and Quality Authority (HIQA) has today published three reports on nutrition and hydration care in public acute hospitals. HIQA monitors against the National Standards for Safer Better Healthcare to review nutrition and hydration care of patients in Irish hospitals.  

HIQA inspections monitor hospitals to ensure that they have effective systems in place to identify and manage patients who are at risk of malnutrition and dehydration. The reports published today relate to inspections in Tallaght Hospital, Beaumont Hospital and University Hospital Limerick.

An unannounced inspection in Tallaght Hospital was carried out on the 18 August 2016. Inspectors found that patients were routinely screened for the risk of malnutrition on admission on some of the wards in the hospital. However, inspectors found that patients on these wards were not always screened for their risk of malnutrition on admission, nor were they re-screened weekly.

While some patients who spoke with inspectors were positive about the meals offered, others offered negative views on the quality of meals. In addition, a small number of patients reported that they had not always received what they had ordered. Hospital managers should ensure that effective communication systems are in place so that patients receive the correct meals, this is particularly important for patients that require texture modified diets or special therapeutic diets.

Inspectors found that the hospital had established a Nutrition Steering Committee which played a key role in raising the importance of the provision of good nutrition and hydration care. A number of quality improvement initiatives relating to nutrition and hydration had been implemented in the hospital.

Several audits on screening patients for their risk of malnutrition and the patients’ experience of mealtimes had been conducted. However, it was noted that the hospital had not audited the nutrient content and portion sizes of hospital meals as recommended in the national guidelines.

During an unannounced inspection in Beaumont Hospital on 10 August 2016 inspectors found that patients were routinely screened for the risk of malnutrition on admission on some of the wards. However, inspectors found that screening was not always carried out for patients in a timely manner.

Inspectors observed that patients who required assistance were offered it in a prompt manner. All patients were offered a choice of meals including patients on texture-modified diets. While most patients were positive about the meals offered, other patients offered mixed views on the meals. A small number of patients reported that they had not always received what they had ordered.

The hospital had a Nutrition Steering Committee that played a key role in raising the importance of the provision of good nutrition and hydration care across the hospital and the Committee had implemented a number of quality improvement initiatives.

A number of audits in relation to nutrition and hydration care were conducted in the hospital, including regular audits on screening patients for their risk of malnutrition and patients’ experience of mealtimes. Inspectors concluded that the hospital needs to progress with the development, approval and implementation of nutrition and hydration policies to standardise nutrition care and meal service provision at the hospital.

An unannounced inspection of University Hospital Limerick was carried out on 24 August 2016. Inspectors observed that the hospital routinely screened patients on all wards for their risk of malnutrition within 24 hours of admission to hospital. However, weekly re-screening was not always carried out.

While the majority of patients spoken with by inspectors were complimentary about the choice, taste and temperature of food and drinks available in the hospital, some patients told inspectors that meal times, especially the evening meal, was too early.

Inspectors observed that not all patients who required assistance were offered it in a prompt manner and there was no system in place to alert catering staff as to which patients needed assistance with meals. Patients told inspectors that there were unnecessary interruptions to mealtimes from hospital staff and visitors, and this practice was observed by inspectors on all three wards inspected.

The hospital had a Nutrition Food and Hydration Committee in place and had implemented a number of quality improvement initiatives relating to nutrition and hydration. A number of audits had been conducted by the hospital including audits of the nutrient content of standard menus. However, inspectors noted that not all menus offered to patients had been audited for their nutrient content.