Patient safety and human factors: RCN programme - nutrition and hydration

Situation

Inadequacies in nutritional care in all care settings have continued to be highlighted as a patient safety issue. Key concerns reported are failures to assess and monitor patients effectively, mealtimes that are insufficiently protected and supported by staff, and the consequent impact on patient outcomes.

Malnutrition and dehydration, particularly in older and more vulnerable people, remain significant problems in care settings and the community, and in the transfer between the two (Age UK 2010, Care Quality Commission 2011; Healthcare Improvement Scotland 2012).

Background

The drive to improve quality has prompted initiatives in all of the UK countries and from key organisations. This includes the learning area on basic nutritional care, published in 2010, as part of the Royal College of Nursing (RCN) CPD online learning (RCN 2010a).

Learning from an earlier RCN initiative – the Nutrition Now campaign, which developed resources and influential training materials, also contributed to the Care Quality Commission (CQC) prompts for inspectors using observation to monitor compliance with standards (Care Quality Commission 2010).

Actions

The aim in developing the online resource is to signpost the quality improvement products from across the UK resulting from this drive for improvement, and to include practice examples which demonstrate the learning translated into practice.

The resource also underlines the key role that the nursing family plays in the many different aspects of nutritional care through using the RCN Principles of Nursing Practice as a framework for the content (RCN 2010b).

Results

The Nutrition and hydration resource was launched in January 2012 in time to support a major learning initiative run by Patient Safety First further reinforcing the importance of good nutritional care in the safe and effective care of patients in all settings. Regularly updated the flexible structure also enables further development in any specific areas required. The resource demonstrates how the RCN Principles of Nursing Practice can be applied to a particular area of care to make clearer what the nursing contribution is and how it can be improved.