Nutrition and hydration is frequently poorly managed but implementing some simple steps can significantly improve mortality and morbidity.
Medical evidence shows that good hydration can assist in the management of diabetes and help prevent many other medical conditions 1. Similarly, meta-analyses suggest that provision of nutritional supplements to malnourished patients reduces complications such as infections and wound breakdown by 70% and mortality by 40% 2.
Resources in this section include toolkits for improving nutrition and hydration in both primary and secondary care, and guidance for organisations and commissioners to develop services to support best practice.
Support for professionals
Support for healthcare professionals, particularly in the community, to undertake nutritional screening and identify malnutrition and disease related malnutrition is provided in Managing adult malnutrition in the community. It includes an evidence-based management pathway for using oral nutritional supplements and also guidance on the use of individualised multiple-disciplinary interventions.
The British Association for Parenteral and Enteral Nutrition have developed a nutrition strategy for commissioners incorporating screening, care pathways, education and management structures. This is brought together in Malnutrition Matters: Meeting Quality Standards in Nutritional Care, a toolkit for commissioners and organisations. It also includes tools for assessing and optimising current service provision.
It is important to identify barriers to the provision of good nutritional care in order to improve services and reduce harm. These barriers are discussed a the paper in Proceedings of the Nutrition Society. The key finding is that the greatest barrier to good nutritional care is a lack of knowledge around nutrition and that a multi-component approach is likely to be the most successful to improve services.
Adequate hydration is a vital component of good nutrition that may be over-looked. The Royal College of Nursing, have introduced a toolkit to emphasise the importance of hydration in good care. This provides evidence on harm associated with dehydration and includes practical ideas for incorporating provision of fluids within nursing care in hospitals and the community.
- Water for Health: Hydration Best Practice Toolkit for Hospitals and Healthcare, Royal College of Nursing, 2007. http://www.rcn.org.uk/newsevents/campaigns/nutritionnow/tools_and_resources/hydration Accessed 15th April 2013
- Malnutrition Matters Meeting Quality Standards in Nutritional Care, BAPEN Quality Group, 2010. http://www.bapen.org.uk/pdfs/toolkit-for-commissioners.pdf Accessed 15th April 2013