Hospital Hydration Best Practice Toolkit

TheHospital Hydration Best Practice Toolkit is an online resource developed through partnership working with nurses, patient groups and key stakeholders - including the National Patient Safety Agency (NPSA), the RCN and Water UK - to encourage hydration best practice in the hospital environment.

About the toolkit

The Hospital hydration best practice toolkit provides practical advice for health care staff in England and Wales on how to minimise the risk and potential harm that dehydration can cause, and offers solutions to improving the provision of water to patients in hospitals.

The RCN and the NPSA believe that if we are to make good hydration a top priority, everybody in the hospital environment - from the catering staff through to the chief executive - needs to play a part. 

Both organisations are working together with health care staff to continue to raise awareness of the importance of water and hydration to patient health, and ensure that the provision of water is a fundamental aspect of nutritional care.

Contents of toolkit

The toolkit contains the following information:

  • the health and economic benefits of providing water
  • medical evidence about hydration and dehydration
  • frequently asked questions
  • facts about water
  • practical tips for encouraging water consumption
  • a sample menu for providing adequate fluids within health care
  • information about hospital guidance and standards

Key messages for health professionals

  • It's vital you encourage patients to drink more. Providing fresh water helps keep patients hydrated and improves their wellbeing.
  • Water is one of the six basic nutrients.
  • Being well-hydrated helps medicines work more effectively and helps combat the diuretic effect of some medicines.
  • Medical evidence shows drinking plenty of water can assist in preventing, treating and managing a wide range of conditions including cancer, diabetes and heart disease.
  • NHS guidance states that, where clinically appropriate, patients should drink 2.5 litres of water a day - or half a litre with every meal.
  • Change water jugs regularly (a minimum of three times a day) so that drinking water is always available, appealing, fresh and cool.
  • Tap water tastes best when it is served fresh and chilled.
  • Be cautious when offering squash or cordials to patients. They are useful when diluted, fortified and sugar-free. Avoid serving strong, high-sugar solutions.
  • Water is inexpensive: a hospital patient could drink two litres of tap water a day for nearly five months and cost the NHS just the price of a first class stamp.

Clinical facts

  • Medical evidence shows drinking enough water can assist in preventing or treating pressure ulcers, urinary infections, heart disease, low blood pressure, and diabetes.
  • Research also suggests it could reduce the risk of developing cancer of the large bowel, the breast, the prostate and the urinary tract; reduce the risk of kidney stone formation by 39%; and reduce the risk of coronary heart disease by 46% in men and 59% in women.
  • On the other hand, dehydration has been shown to increase by two-fold the mortality of patients admitted to hospital with a stroke, and increase the length of hospital stay for patients with community-acquired pneumonia.

Download the toolkit

The toolkit contains 13 factsheets and a cover, which can be downloaded either as one complete file or as separate files. Please note this is an online publication only. [See how to access PDF files]

Download the complete version of toolkit (PDF 2.8MB)

Toolkit cover (PDF 1.2MB)

Factsheet one: Introduction to the toolkit (PDF 251KB)
Factsheet two: The health and economic benefits of providing water (PDF 146KB)
Factsheet 3.1: Hydration and healthy ageing (PDF 119KB)
Factsheet 3.2: Water and cancer prevention (PDF 179KB)
Factsheet 3.3: Water in the workplace (PDF 226KB)
Factsheet four: Frequently asked questions (PDF 199KB)
Factsheet five: Facts about water as a nutrient (PDF 178KB)
Factsheet six: Practical tips for encouraging water consumption (PDF 149KB)
Factsheet seven: Sample menu for providing adequate fluids within health care (PDF 79KB)
Factsheet eight: Hospital guidance and standards (PDF 151KB)
Factsheet nine: How good are your water facilities? (PDF 154KB)
Factsheet 10: Try the hydration awareness quiz (PDF 168KB)
Factsheet 11: Hospital water audit (PDF 148KB)

Clinical evidence

Go to Hydration clinical evidence for links to references used in factsheets 3.1 (Hydration and healthy ageing), 3.2 (Water and cancer prevention) and 3.3 (Water in the workplace).

Toolkit partners

The toolkit has been created through the cooperation and assistance of the following organisations, who formed the project team
and provided the concepts, outline and supporting material:


"Nurses care deeply about good patient nutrition and hydration, and it is vital for everyone, especially when we are ill. The Royal College of Nursing believes that if we are to make hydration a top priority, then everybody in the workforce from the catering staff through to chief executives will need to play a part. This hydration best practice toolkit will help to ensure that it is achieved."

Geraldine Cunningham, former Head of Institute of the Royal College of Nursing

"The National Patient Safety Agency (NPSA) have recognised that dehydration has the potential to cause unnecessary harm to patients, and we are delighted to have collaborated with key stakeholders on the development of this toolkit. Water is a basic nutrient which is essential to health - medical evidence shows that good hydration can assist in the management and prevention of many medical conditions that cause harm or distress to patients in hospitals."

Martin Fletcher, Chief Executive of the National Patient Safety Agency (NPSA)

"The Patients Association support the principles of this toolkit, and commends the voluntary health partnership that created it. I believe it will make a valuable contribution to the health and quality of life of hospital patients and their families."

Pamela Taylor, Chief Executive of Water UK 

complete list of endorsements (Word 32KB) is available for you to download.