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 Nenagh Hospital, Tipperary; Our Lady’s Hospital, Navan; and Portiuncula University Hospital, Galway.

An unannounced visit to Nenagh Hospital on 13 September 2016 found that the hospital routinely screened patients for their risk of malnutrition within 24 hours of admission to hospital and patients were rescreened weekly in line with national guidelines.

Most patients were satisfied and complimentary about the choice, taste and temperature of the food and drinks available.There was a good variety of choice for patients on standard, therapeutic and texture-modified diets. Nonetheless, some patients told inspectors that the evening meal was served too early.Inspectors observed that all patients who required assistance were offered assistance in a prompt manner, and protected mealtimes was observed to be working well at the hospital.

The hospital was represented at the University of Limerick Group’s Nutrition, Hydration and Food Committee, and this played a key role in raising the importance of the provision of good nutrition and hydration care across the hospital. There was evidence that the hospital had audited aspects of nutrition and hydration care and was progressing with an analysis of the nutrient content of the standard menus.

Inspectors found that the recent appointment of a dietician to the hospital was a welcome development to ensure that all patients identified to be at risk of malnutrition are referred for a specialised nutrition assessment in a timely manner.

During an unannounced inspection of Our Lady’s Hospital, Navan, on 6 September 2016, inspectors found that patients were being routinely screened for their risk of malnutrition on admission to the hospital.

Inspectors spoke with a number of patients during the inspection, who were complementary about the quality of food and drinks that they received and confirmed that they got a number of menu choices. Inspectors observed that patients who required assistance with meals were offered it in a prompt manner.

The hospital had established a Nutrition Steering Committee that had implemented a number of quality improvement initiatives relating to nutrition and hydration, including screening patients for their risk of malnutrition and the development of a number of policies in relation to nutrition. The hospital had carried out some audits on aspects of nutrition and hydration care. However, they had not audited the nutrient content and portion sizes of meals in line with national guidelines.

Inspectors found that the hospital had not engaged with patients to get their views of nutritional and hydration care and the hospital food service. This engagement could inform and direct change or reinforce good practices where it exists.

An unannounced inspection of Portiuncula University Hospital was carried out on 20 September 2016. Although the hospital had introduced screening for all patients to identify those at risk of malnutrition, inspectors found that malnutrition screening was not always carried out within 24 hours of admission and that weekly re-screening was not always carried out in line with hospital policy.

Patients were offered a choice of meals, and the majority of patients were satisfied with the quality of the food offered. Inspectors observed that patients who required assistance were offered assistance in a prompt manner.

The inspection team found that the hospital had an established Nutrition Steering Committee that had implemented a number of quality improvement initiatives relating to nutrition and hydration and had conducted a number of audits of nutrition and hydration care, including an audit of the nutrient content of food. The committee had also carried out regular patient experience surveys of the meal service. However, further improvement was required in relation to screening patients for the risk of malnutrition and the development of policies relating to nutrition and hydration.