Malnutrition risk ‘missed’ as shortcomings found in three acute hospitals
The Health Information and Quality Authority (Hiqa) published reports yesterday on unannounced inspections carried out during July in Mallow General Hospital, Co Cork, University Hospital Kerry, and Midland Regional Hospital, Mullingar.
Inspectors who visited Mallow General Hospital found it had a nutrition steering team, but it did not routinely screen patients for their risk of malnutrition on admission to hospital.
While patients were satisfied with the choice of food offered, inspectors found the selection and variety of texture-modified diets were limited. They also found snacks provided to patients were limited to tea and biscuits, which was not in line with best practise guidelines.
The hospital was conducting some audits about nutrition and hydration care but had not checked the nutrient content and portion sizes of hospital meals. Inspectors also found that the hospital needed to develop policies and provide structured training for staff about nutrition and hydration.
Meanwhile, inspectors who visited University Hospital Kerry found that not all patients needing help with their meals were offered help in a prompt manner. Also, there was no system to make sure that staff who served meals knew which patients needed assistance.
The hospital had a nutrition steering committee and screened patients for their risk of malnutrition on admission, but not all patients were rescreened.
Inspectors also found the hospital had not audited the nutrient content and portion sizes of meals.
During a visit to the Midland Regional Hospital, inspectors concluded that the choice and variety of texture-modified diets was limited. Inspectors also saw patients’ mealtimes being interrupted by medication rounds and the taking of blood samples, but they also observed nursing and healthcare staff helping patients with their meals in a timely way.
Only half of the patients whose records were reviewed by inspectors had been screened for their risk of malnutrition, and not all scores were recorded accurately.
Also, not all patients had been rescreened for their risk of malnutrition in line with national guidelines.
All of the hospitals were advised that a key feature of the improvement process was the evaluation of patients’ experience of nutrition and hydration care and using their views to inform and direct change or to reinforce good practices.
