Drinking Water in Hospitals and Care Homes

1
Drinking Water in Hospitals and Care Homes

• Debbie Dzik- Jurasz
• Caroline Lecko

2
Aims of this presentation

• To provide some background information about
  issues of drinking in hospitals and care homes
• To share some of the work we are doing with other
  members of the Water for Health Alliance to try
  and improve the issues

3
The RCN and the NPSA

• The RCN aims to enhance the working lives of
  nurses and enhance nursing practice
• The NPSA co-ordinates and learns from patient
  safety incidents occurring in the NHS

4
Water is important

• We all need water
• People who have been in hospital and care homes
  often say
• .. I was not helped to drink
• the water did not taste nice

5
Nutrition and Hydration Patient Safety Themes

• Dehydration
• Choking
• Nil by Mouth Prolonged periods of time
• Nil by Mouth Patients fed

• Inappropriate diet and fluids
• Incorrect artificial nutrition
• Transfer of care
• Lack of assessment
• Lack of equipment

6
Key Themes

• Dehydration
• 97 incidents reported to the National Reporting
  and Learning System over a 12 month period
• Involved all healthcare settings
• Included the provision of oral fluids
• Often in transfer of care situations

7
What are the issues?

• Lack of ownership in the responsibility of
  providing fresh drinking water
• Is tap water sexy??
• Hydration not high on the agenda just look at
  the NHS jug!

8
(No Transcript)
9
What are the issues?

• A HEALTH watchdog has upheld claims that an
  elderly patient at the . Hospital died in agony
  and was left wearing soiled clothes and without
  drinking water.
• The Healthcare Commission is now demanding
  hospital staff undergo training in "basic care"
  and that bosses carry out a "review of the
  fundamental elements of care".
• Wednesday 23rd May 2007

10
Some of the issues

• Food and drinking is not viewed as part of
  clinical care
• I dont do food.
• We dont have time for the fundamentals of
  care
• Lack of ownership and responsibility
• How difficult is it to weigh a patient?
• Focus not on oral food
• I dont understand what the problem is with
  SIP feeds?

11
More of the issues

• 2005 Healthcare Commission England and Wales
• of patients who needed help to eat their meals
  (a fifth of those surveyed), almost 40 said that
  they either never (18 ) or only sometimes (21)
  received help

12
What we want to do

• We are trying to address some of these issues in
  the following ways
• Working in collaboration with members of Water UK
• The NPSA are working to build a picture as to the
  severity of the problem of dehydration in
  healthcare
• The RCN campaign on food hydration and nutrition

13
Some of the initiatives

• Promoting Protected Mealtimes
• Promoting Nutritional assessment
• A poster - about water
• A toolkit- about water
• Education

14
(No Transcript)
15
(No Transcript)
16
The toolkit

• The RCN, NPSA, NHS Supply Chain, HCA, HeFMa and,
  of course, Water UK have worked together to adapt
  the hydration toolkit to make it fit for purpose
  for use in the hospital environment
• An excellent example of key stakeholders working
  together to improve patient care.

17
Closing thoughts

• 1859 Florence Nightingale
• thousands of patients are annually starved in
  the midst of plenty, from the want of attention
  to the ways which alone make it possible for them
  to eat

18
Thank you for listening Debbie.dzik-jurasz_at_rcn.or
g.uk caroline.lecko_at_npsa.nhs.uk