Hospital nutrition even more important during the Festive season

Dr Tim Bowling, Chair of BAPEN, says:

"Whilst menus provided in hospital must be appealing and the food served nutritious, what is even more important is how much of the food and drink chosen by and presented to patients has actually been consumed. Patients who are ill and in hospital usually have small appetites and their choice of food and enthusiasm to eat does not often coincide with meal times, as dictated by kitchen timetables and staffing rotas. But to give patients the best chance of recovery and reduced risk of complication and infections, intake of food and drink must be maintained. Hospitals and staff must have whole systems in place to monitor intake of food and drink and to take the right action if these levels are not adequate."

BAPEN has been directly involved with the development of a new whole hospital system, the hospitalfoodie programme, led by the University of Newcastle, and funded by the joint Research Councils led by the ESRC under the New Dynamics of Ageing work stream to address this challenge.

The hospitalfoodie system has been developed to ensure consistent delivery of nutritional care for older people in hospitals. It delivers this by focusing on two core principles:

  1. Recording and monitoring what has been eaten and drunk is more important than simply recording what has been provided from a set menu.
  2. Action is taken when intake is shown to be inadequate by providing energy dense foods and drinks at ward level.

The development of hospitalfoodie has been driven by a multidisciplinary research team from the Universities of Newcastle, Reading and Glasgow School of Art. It has brought designers, dietitians, geriatricians, gerontologists, food scientists and computing science experts together with older people, caterers, nurses, managers and charities such as BAPEN.

Whilst hospitalfoodie has been developed with older people at its heart, the system is intended for use across whole hospitals for all age groups. "hospitalfoodie has the potential to meet the needs of all patients in hospital," says mappmal lead Professor Paula Moynihan of Newcastle University. "By concentrating on older people, who often have the most complex health needs, we believe we have developed a system that will promote good nutritional care in people of all ages and with all conditions to give them the best chance of recovery."

The hospitalfoodie system combines a bed-side touch screen that enables staff to measure and monitor nutrient intake and prompts remedial action, with pre-meal checklists for staff to enable both carer and cared for to be better prepared and anticipating meals, and with a ward-based mini-meals unit so that nursing and care staff can promptly support patients to select and eat or drink additional items. The technology that makes all this possible was developed by experts in the Design School at The Glasgow School of Art in liaison with computer scientists from Newcastle University.

The system has been designed to be as clear, accurate and easy-to-use for all concerned and has been informed by end user involvement," said Professor Alastair Macdonald of The Glasgow School of Art.

The mappmal team has also developed nutrient dense food items such as ice-cream and biscuits which have been taste-tested and won the approval of older people, professionals and individuals taking part in the study.

"Older patients generally have small appetites and do not want to eat large meals; in addition they often suffer from deterioration in their ability to taste food. With this in mind, we have developed foods that are small portion sizes yet high in nutritional content and taste to consume any time of day," said Dr Lisa Methven of the University of Reading.

"Whilst the current climate may prove challenging for hospitals to consider investing in systems such as hospitalfoodie," concludes Dr Tim Bowling, "the evidence is over-whelming that without a change in systems, coupled with a commitment to training, many Trusts and individual wards will fall far short of both the expectations of regulators and of patients and their families. hospitalfoodie presents a vision of how nutritional care can be provided in hospital, one where we would all be happy to see our grandparents, parents, ourselves and indeed our children receiving care. It certainly has the potential to reduce inconsistencies in the delivery of nutritional care so starkly highlighted by the recent Care Quality Commission inspections."

Interviews are available with Dr Tim Bowling of BAPEN.

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More information on hospitalfoodie is available on the project website www.hospitalfoodie.com

BAPEN is the multi-professional registered charity committed to combating malnutrition and promoting excellence in nutritional care in hospital, care homes and the community. www.bapen.org.uk Registered Charity No. 1023927

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