Nurses must be better trained and take more responsibility in ensuring patients are not malnourished, a hard-hitting report has warned.
The Nutrition Action Plan Delivery Board report, commissioned by the Department of Health, found not enough attention is being paid by organisations or healthcare professionals to prevent patients from becoming malnourished.
It says: “At the extreme, some of those people die because our health and care system is not meeting some of their most basic needs.”
In many more cases, “recovery is delayed and long-term decisions are taken which affect the whole of people’s future lives”, it says. This is “simply because sufficient attention is not paid to nutrition and one of the most basic responsibilities of clinicians and care workers: to ensure that people in their care…take in the food and water which they need”.
The report warns that messages around nutrition are not getting through to frontline staff, possibly because national campaigns have focussed on obesity rather than the dangers of being underweight.
The board has updated guidance for professionals (see box). It also calls for a recognised training module for all clinicians in supporting patients’ nutritional wellbeing.
NHS Tameside and Glossop nutrition nurse specialist June Shepley said a lack of staff in hospitals sometimes made it difficult to ensure protected mealtimes were kept to.
She said the malnutrition universal screening tool – highlighted in the report as a useful way of tracking patients’ levels of nutrition – could be difficult to use and required specific training, but a simplified, three step, version was working well in some organisations.
The Department of Health said it would continue to address nutritional issues through new regulations and the chief nursing officer’s eight high impact actions.
The Ten Key Characteristics of Good Nutritional Care
• Food service and nutritional care is delivered safely
• An environment conducive to people enjoying their meals and being able to safely consume them
• Multi-disciplinary approach, valuing contributions of staff, patients, carers and volunteers
• Specific guidance in service delivery and accountability arrangements
* Universal screening to identify those who are malnourished or at risk of becoming so
• Facilities and services designed to be flexible and centred on the needs of patients
• Patients to have a personal care/support plan to identify nutritional care and fluids needs
• All staff/volunteers to have appropriate skills and competencies and receive regular training
• Patients involved in planning and monitoring arrangements for food and drinks provision
• Providers to have policy for food service and nutritional care, centred on the needs of users