Malnutrition remains a major healthcare problem affecting a significant number of patients admitted to UK hospitals and care homes. Dr Ailsa Brotherton, chair of the British Association for Parenteral and Enteral Nutrition (BAPEN) Quality and Safety Committee, provides an insight into best practice measures in nutritional care.
The largest nutrition screening survey undertaken in the UK by BAPEN found malnutrition is a major health problem affecting around a quarter of patients admitted to hospital and a third of residents admitted to care homes, yet there has been no widely available measurement tool to measure the quality of nutritional care patients receive. Failures in trusts and care homes to meet the required standards of nutritional care for patients and residents have been highlighted in recent years, resulting in a number of inspections and a plethora of nutritional standards and initiatives all aiming to improve the quality of nutritional care that is delivered.
Some progress has been made and there are undoubtedly pockets of excellent practice, but care across the UK remains fragmented and we have been unable to eliminate the unnecessary variation that exists within and between hospitals and other care settings. To date, most organisations have focused on measuring their compliance to nutritional screening on admission and on the implementation of catering standards with little, if any, focus on measuring the quality of nutritional care actually provided, even though there are standards outlining the quality of care that should be delivered. It would be totally unacceptable to offer screening programmes for diseases such as cancer, dementia and diabetes that didn’t then provide and measure the provision of appropriate treatment. The same principle applies to the early detection and treatment of malnutrition; so why does it remain so difficult to deliver good nutritional care and to measure the quality of care that patients receive.
This article highlights the importance of good nutritional care and outlines how organisations can implement a new tool to measure the quality of their nutritional care, highlight where variation exists and identify where they need to make improvements in a ward. The dashboard tool can also be used in care homes and provides assurance evidence for management teams and trust boards.
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