Standards and Guidelines for Nutritional Support of Patients in Hospitals
BAPEN set up a Working Party to consider the setting of standards for the nutritional support of patients during their stay in hospital, as one of the principal aims of the Association. The Report of the Working Party's findings, edited by its Chairman, Mr Tim Sizer, consultant pharmacist and former Director of Pharmaceutical Production, Cheltenham General Hospital, was published in May 1996.
The provision of adequate nutritional support can only be effective if health care professionals adopt agreed standards of practice. The Kings Fund Centre Report "A positive approach to nutrition as treatment", published in 1992, highlighted the lack of national standards for support and called for such standards to be established.
That a need for standards in this field still exists has been clearly shown in recent surveys, which have revealed that under-nutrition in hospitals is common and infrequently recognised. 1,2
Malnutrition delays patients recovery, increases the incidence of serious complications and increases treatment costs.
However, simply encouraging patients to eat more is only part of the answer. Supervision of nutrient intake is important.
The appropriate and carefully considered use of supplements, whether oral, via an enteral tube feeding or intravenous, can transform a patient's recovery.
What the Working Party Found:
Because of their illness, many patients enter hospitals nutritionally depleted, and many leave the hospital even more malnourished! The reasons for this are many, but the problem is compounded by the fact that malnutrition often goes unrecognised and untreated because formal assessment of nutritional status is not yet a routine procedure in many hospitals.
In addition there is a general lack of awareness of the problems of malnutrition among health care professionals and managers of health services. If asked, many would consider malnutrition to be a problem experienced only in third world nations.
While it is true to say that many hospitals do address this issue, the provision of nutritional support throughout the UK is uneven. In many hospitals standards and systems of audit for nutritional support either do not exist or are not regularly applied.