Three quarters of Scottish nurses confident that malnourished relatives entering hospital would be noticed
01 September 2010
77% of Scottish nurses are confident that hospital staff would notice if a relative was malnourished when entering hospital, as opposed to 68% in England, according to a recent survey for Age UK conducted by ICM.
Recognition of malnutrition in hospitals has been greater in Scotland than in other parts of the UK, partly because the NHS in Scotland started tackling the issue in 2001, when a working group was established to develop mandatory standards for nutrition, which were published in September 2003 following a wide-ranging consultation.
The six formally-required Scottish standards regarding nutrition in hospitals cover Policy & Strategy, Assessment, Screening & Care Planning, Planning and Delivery of Food & Fluid, Provision of Food & Fluid to Patients, Patient Information & Communication, and Education & Training for Staff.
An Age Scotland survey in 2008/9 revealed that almost half of older patients (48%) rated the food they received during a stay in a Scottish hospital as ‘Good' or ‘Very Good' although 34% rated it as ‘Poor', in comparison to what they ate at home.
The questionnaire did however expose problems with older patients filling out menu cards, having liquids within reach at meal times, obtaining assistance in eating their meals, having enough time to finish those and not being interrupted whilst eating.
This survey suggested that although standards of nutritional care in NHS hospitals in Scotland had clearly improved since 2000, when Kelly et al's study from Glasgow Royal Infirmary showed that malnutrition in acute hospital admissions went unrecognised and unmanaged in 70% of cases, they were not being fully adhered to across the country.
Age Scotland believes this is still the case, and would like to see this addressed as a matter of urgency.
Other important national variances thrown up by the Age UK survey included:
- 5% more Scottish nurses (82%) saw reducing malnutrition in hospitals as one of the three most important issues for the NHS to address than England.
- The largest percentage of nurses across the UK, when asked how well they thought they performed in relation to standards of care and evaluation in this area and answered ‘to a high standard', came from Scotland with 10%. England's response was 4% and Wales' 2%.
- 9% of Scotland and Northern Ireland's participating nurses stated that they use the MUST screening tool, which identifies any malnutrition problems, compared to England's 3% and Wales' 5%.
- 9% of England's participating nurses claimed that staff are under pressure and lack significant time to provide necessary care to help feed patients. Scotland and Wales had no one expressing the same concern.
- Although the percentage of nurses participating who commented that the NHS required ‘more staff to help feed patients/ensure patients eat' was quite low, (England 3%, N.I. 4% and Wales 3%), not one of the Scottish respondents identified this as an issue.
David Manion, Chief Executive of Age Scotland said: "It's reassuring that the vast majority of Scottish nurses are confident that malnourishment will be picked up when an older person enters hospital, however, there is no room for complacency when it comes to this still prevalent problem.
"While recognition of the issue is high, more needs to be done to ensure that implementation of the standards countrywide is properly audited. This is of the utmost importance as the health benefits to older people would be significant and it would offer savings to the health service."