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 St. James’s Hospital, Dublin, Letterkenny University Hospital, Co Donegal, and South Infirmary Victoria University Hospital, Cork.

An unannounced inspection of St. James’s Hospital was carried out on 26 October 2016. Inspectors observed that the hospital routinely screened patients for the risk of malnutrition within 24 hours of admission to hospital.

The majority of patients told inspectors that they were satisfied with the meal service and the number of choices offered. All patients were offered a choice of meals including patients on texture-modified diets. However, a number of patients told inspectors that they sometimes experienced interruptions during their meals, and some meals were served too early. This was consistent with the findings from the catering service patient experience surveys. Inspectors observed that patients who required assistance were offered it in a prompt manner.

St. James’s Hospital had an established Nutrition Steering Committee in place that played a key role in raising the importance of the provision of good nutrition and hydration care across the hospital. A number of quality improvement initiatives relating to nutrition and hydration had been implemented. Inspectors noted that the hospital had a good patient safety reporting culture for incidents relating to nutrition and hydration allowing greater opportunities to learn and improve practice.

Inspectors found that the hospital had conducted a number of audits including auditing the nutrient content and portion size of food and compliance with the implementation of screening for the risk of malnutrition.

An unannounced inspection of Letterkenny University Hospital was carried out on 10 November 2016. On the day of inspection, inspectors found that the hospital routinely screened patients for the risk of malnutrition within 24 hours of admission to hospital.

Patients spoken with during the inspection generally spoke positively about the food available and said that the food was served hot, where appropriate. However, inspectors found that there was a lack of choice available to all patients. The hospital had a system in place to identify patients who needed assistance with eating and drinking. Inspectors observed that nurses and healthcare assistants provided patients with assistance as required, on the day of inspection.

An established Nutrition Committee was in place in the hospital. The Nutrition Committee played a key role in raising the importance of the provision of good nutrition and hydration care across the hospital and had implemented a number of quality improvement initiatives. Inspectors found that the hospital had conducted a number of audits in relation to aspects of nutrition and hydration care including an analysis of nutrient content of menus. The hospital had also conducted patient satisfaction surveys that included questions on the patients’ experience of mealtimes.

An unannounced inspection of South Infirmary Victoria University Hospital was carried out on 15 November 2016. Inspectors found that the hospital was screening some, but not all, patients for their risk of malnutrition. The hospital should proceed with the implementation of screening and rescreening for all patients in the hospital, in line with the national guidelines.

The majority of patients who spoke with inspectors were satisfied with the quality of food and drinks that they received while in hospital. Inspectors found that there were a number of menu choices available for patients on standard and therapeutic diets. However, patients on texture-modified diets had limited choice. The hospital had a system in place to identify patients who needed assistance with eating and drinking. Inspectors observed that patients who required assistance were offered it in a prompt manner.

The hospital had a Nutrition Steering Committee in place that played a key role in raising the importance of the provision of good nutrition and hydration care across the hospital. Inspectors found that the Nutrition Steering Committee had carried out a number of audits on aspects of nutrition and hydration care including auditing the nutrient content and portion size of meals. They had also carried out patient experience surveys. However, inspectors found that the hospital had not audited compliance with their screening tool used to screen patients for risk of malnutrition.