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Malnourished patients go unnoticed

Almost a third of nurses are not confident that a malnourished relative would be spotted if admitted to hospital, a survey by charity Age UK has found.

Of the 1,000 NHS hospital nurses who took part, less than half said their hospital screened older patients often enough for malnutrition and only a third said patients were routinely screened for malnutrition when admitted. Just 5 per cent said older patients were screened for malnutrition on discharge.

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The survey marked the launch of Age UK’s report into malnutrition among older people in hospital, Still Hungry to be Heard, which follows the campaigning report Hungry to be Heard, published four years ago.

The charity described it as “a national disgrace” that around 180,000 patients a year were discharged with malnutrition from English hospitals and has called on the government to introduce compulsory recording of malnutrition rates.

Age UK is also demanding that ward staff are trained in screening techniques, and wants the Care Quality Commission to undertake a comprehensive review of how hospital mealtimes are organised.

Keeping nourished - getting better, is one of the eight high impact actions for nursing and midwifery produced by the NHS Institute for Innovation and Improvement to tackle malnutrition in hospitals. It recommends screening for malnutrition in all hospitals, as well as measuring and recording malnutrition locally.

Age UK head of campaigns Ray Mitchell told Nursing Times that although input from government and the CQC was needed, the type of work outlined in the high impact action would be key to reducing malnutrition levels.

“What we discovered was that good practice often starts with ward nurses who see that a problem with malnutrition needs addressing,” he said.

“Where we found protected mealtimes operating well, for instance, it was often nurses championing it that had helped build that in at some hospitals”.

He said nurses often wanted to screen patients, but had told Age UK they could not due to a lack of training and time, and other tasks having a higher priority.

Readers' comments (10)

  • Reluctant to say it but don't think the majority of nurses would know if a patient had eaten their meal whilst in hospital, let alone recognise malnutrition

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  • Anonymous | 31-Aug-2010 6:39 pm, I know. Isn't it awful that the one staff Nurse on duty cannot individually check every one of the 31 or so patients they have because of those annoying little things like emergencies, clinical tasks, MDT attention and paperwork. Awful.

    That was sarcasm by the way, I know a lot of people on here need things spelled out for them.

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  • In our hospital meals are delivered by a catering service. I see it happen all the time: meals are put in front of patients and taken away after some time. No checking if the patient has actually eaten, of if they could even reach the food!
    Thats what happens when this is taken away from nurses! I am "old school" and when I was a trainee nurse one of the important jobs would be to monitor patients food intake.

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  • I work in an Aged Care Fascility in Australia and I am frustrated constantly with the fact that there are so many Seniors that need assistance with meals and dont get it due to staff shortages or poor management. I constantly see trays taken away before the Resident has finished or before someone has been able to get to them to feed them. The lucky ones get half a meal and cold at the best of times. Malnutrtion? Blind Freddy could see that!

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  • Anonymous | 1-Sep-2010 9:07 pm I absolutely agree with you on the importance of monitoring nutritional intake, that is a given. However, it is not a matter of being 'old' or 'new' school; as always, it always boils down to staff. As I am sure you know, when you have to deal with a patient whose tanked, or have the meds to give out or a dozen or so drips to put up or PEG feeds to sort out (etc ad nauseum), then sitting down and helping to feed those patients who need it simply cannot be done. We rely on HCA's to do this for us and report wether the patient has eaten well or not, but yet again, there often simply isn't enough of them either. As a result when the outsourced catering services come and swipe the trays away whilst we are in the middle of something else, not really caring wether the patients have eaten or not, how are we to know? What are we to do?

    Everyone knows how to sort this out, yet it will never get done because of money, and yet again the Nurse will be the one who gets the bloody blame.

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  • Gemma Watford

    I agree with all the above commetns on this issue. There needs to be adequate staffing, so that a patient's intake of food is monitored. Lets get this hungry to be heard campaign out on the road, and ask older people what they think about this issue, after all they're the service users at the end of the day, and may know a thing or two about what consists a good meal. Lets also give the MUST screening tool, objectives to HCAs as they are the ones actually doing the bedside nursing now, and they could be easily trained in how to use it, feering up trained nurse time, to do rug rounds, PEG feeds, IVs etc. common sense always worked, so lets get back to it.

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  • It would also help if the food was palatable and had more fresh fruit and veg!

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  • It would also help if the food was palatable and had more fresh fruit and veg!

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  • It would also help if the food was palatable and had more fresh fruit and veg!

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  • I work on a busy actue stroke unit where the large majority of our patients are elderly due to the very nature of the condition. I feel we fare very well on recognising malnourished patients, or those at risk of malnoursihment. We weigh all our patients either on their admission or within a couple of days of their admission and complete the MUST risk assessment, then every saturday is our trusts 'weigh day' where every patient gets weighed. Any pts who have lost weight are referred to the dietician. Also, it is ward staff who give out meals and clear them away after mealtimes. After meals are given out, the auxillaries go from bay to bay assisting those who need assisting with meals and documenting how much pts have actually consumed. However there is only so much the staff can do, I have often encountered elderly patients who day after day genuinely refuse food due to depression/ the effects of their ill health.

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