Zero Harm – Good Nutrition & Hydration Launched by Tallaght Hospital
In the same week that HIQA’s published its report on nutrition and hydration care in the public acute hospitals, Tallaght Hospital launched its new campaign in its Zero Harm series, entitled Zero Harm Good Nutrition & Hydration. This latest campaign was a concerted focus on combatting malnutrition educating both staff, patients and their carers. Most patients, and indeed staff working in healthcare, are unaware that on admission to hospital, one in four patients are malnourished. Compared to well- nourished patients, malnourished patients have a much greater risk of infection, longer length of hospital stay, higher risk of readmission and greater mortality risk. And they cost more too, in fact approximately €1.4 billion per year! Conversely, nutrition support has been found to be highly effective in improving patient outcomes and in reducing costs.
With this in mind, the aim of the Tallaght Hospital Zero Harm starts with Good Nutrition & Hydration campaign was to make patients and staff aware of the incidence and causes of malnutrition and the steps that can and should be taken to improve nutritional care for hospitalised patients.
Led by the Department of Nutrition & Dietetics, the campaign team was comprised of staff representing a broad range of disciplines including medical and surgical staff, nursing, healthcare attendants, catering, patient food services, radiology, speech & language therapy, occupational therapy, pharmacy, wound management, medical photography, communications and nurse practice development.
The hospitals executive management team (EMT), including the CEO David Slevin and the Director for Quality, Safety & Risk, Dr Daragh Fahey, all participated in the launch of the campaign which ran over a three day period. EMT members also participated in the ward based programme which achieved the ambitious target of having the multidisciplinary campaign team visit every ward in the hospital, to engage directly with patients and staff and to listen to their comments and suggestions. Zero Harm themed cupcakes, made by the hospital chefs for the occasion, served with the patient’s afternoon tea were a very welcome treat. They were also a very practical way of engaging in a conversation with patients about the importance of nutrition and hydration, needless to say it was a nutritious recipe!
Information stands were manned throughout the campaign providing copies of the resources, policies and guidelines available in the hospital to enhance the nutritional care of patients. Some resources were specially designed for the event including a poster by the nursing staff on “MUST is a Must” to drive home the importance of screening patients for risk of malnutrition on admission to hospital. Visual aids, used to demonstrate the importance of adequate hydration, also proved to be very popular, especially the colourful Pee-O-Meter and the Bristol Stool Chart themed chocolate cake!
Staff were given an opportunity to carry out a MUST screen, taste oral nutritional supplements, try out the special aids and utensils designed to assist with feeding and sample the modified consistency diets prepared by the chefs.
Overall the feedback received from patients regarding their nutritional care was very positive and very complimentary of the food service. However, many recommendations for improvement were received, which when compiled formed seven themes – the timing of meals; the availability of fresh drinking water; the need for mealtime assistance; the busyness of wards during mealtimes; unnecessary fasting; food and menu choices and patient weights. Interestingly, but unsurprisingly, HIQA too referred to all of these points in its recommendations for improving nutrition and hydration care in the acute hospital setting.
No doubt the Tallaght Hospital Zero Harm campaign successfully raised an awareness amongst staff and patients of this important issue. The next steps however will involve capitalising on the enthusiasm generated to bring about the further changes required to implement the recommendations made by HIQA to ensure that patients receive optimal nutritional care whilst in hospital.