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 John’s Hospital, Limerick; Kilcreene Regional Orthopaedic Hospital, Kilkenny; and St Michael’s Hospital, Dun Laoghaire, Dublin.

During an unannounced inspection of St John’s Hospital on 11 October 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 choice, taste and temperature of the food and drinks available. 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, including the nutrient content of the standard menu. However, the nutrient content of texture-modified and therapeutic menus had not been audited.

Inspectors found that the hospital had engaged with patients to get their views of nutrition and hydration care and the hospital food service and was responsive to patients’ feedback.

An unannounced inspection of Kilcreene Regional Orthopaedic Hospitalwas carried out on 19 October 2016. Inspectors found that the hospital routinely screened patients for their risk of malnutrition at the pre-assessment clinic prior to attending the hospital for elective surgery. However, the hospital had not audited this practice at the time of inspection.

Most patients were satisfied and complimentary about the timing and quality of food received. However, the choice of food offered to patients was limited as was the provision of regular snacks between meals.

The hospital had developed a number of policies and guidelines relevant to nutrition and hydration care. The recent appointment of a hospital representative to the University Hospital Waterford’s Nutrition and Hydration Committee is a welcome development.

An unannounced inspection in St Michael’s Hospital on 28 September2016 found that the hospital was screening patients for their risk of malnutrition.All patients who spoke with inspectors were satisfied and complementary about the quality of food they received and choice of meals offered.  However, not all patients on some texture-modified diets were offered a choice of meal.

Inspectors found that the hospital had conducted a number of audits in relation to aspects of nutrition and hydration care, including audits on compliance with screening patients for their risk of malnutrition and the nutrient content of food and portion sizes. The hospital also conducted patient satisfaction surveys that included questions on the patients’ experience of mealtimes.

The hospital had an established Nutrition Steering Committee in place that played a key role in implementing quality improvement initiatives.  There were systems in place to ensure patients received the correct meals, and inspectors noted that the hospital had a good patient safety reporting culture for incidents relating to nutrition and hydration care. Moreover, inspectors observed that patients who required assistance were offered it in a prompt manner.