The nutritional care of patients is not seen as a priority by some Irish hospitals, a review by the Health Information and Quality Authority (HIQA) has found.

As part of this review, HIQA looked at 42 hospitals in total, carried out unannounced inspections in 13 hospitals, spoke with 579 patients and 363 staff, and assessed 322 healthcare records.

Nutrition and hydration are essential to ward off malnutrition, which refers to under-nutrition that affects a person's health and wellbeing. It can come about if the body cannot use food properly, which can lead to a person losing weight and developing nutritional deficiencies. Certain diseases can also lead to appetite suppression.

One in four patients admitted to Irish hospitals are already affected by malnutrition, however screening for this condition varies from hospital to hospital, HIQA found.

"Every patient should be screened for risk of malnutrition within 24 hours of admission to hospital. Our review shows that only half of the 42 hospitals are doing this on more than 75% of wards and one in five hospitals has no system of screening for risk of malnutrition in any area of the hospital.

"Hospitals who have not introduced such screening to date must now proceed, without delay, to implement a system to ensure that all patients are screened for the risk of malnutrition on admission to hospital in line with evidence-based practice," commented HIQA's head of healthcare, Susan Cliffe.

While offering and providing drinking water to patients is a basic care requirement, the review found that even this was not being adhered to in some cases.

This mainly applied to patients in Emergency Departments (EDs), who had been admitted but were waiting for long periods for a hospital bed. There was also a lack of consistency in the meals offered to patients in EDs.

HIQA pointed out that while all 42 hospitals had said in advance that patients had access to fresh drinking water, the inspectors found that water was only topped up by staff during the day in most hospitals if a jug was seen to be empty or if a patient requested it.

In fact, less than one in three hospitals had a system to replenish water jugs with fresh water during the afternoon so as to ensure that patients always had access to fresh water.

HIQA insisted that access to drinking water should not depend on relatives and visitors. It is up to the hospitals to ensure that all patients have access to fresh water as required.

Ms Cliff insisted that nutrition and hydration ‘should be seen as an integral part of a patient's treatment, rather than a ‘hotel service' provided by the hospital.'

"Many patients experience unintentional weight loss of over 10% of their body weight prior to admission and their nutritional status often deteriorates while in hospital. Nutrition and hydration is fundamental to their treatment and recovery plan of care.

"It is recognised internationally that malnutrition and dehydration can compromise the quality of life of patients, affect their recovery and cause unnecessary illness and death. In patients at risk, it can go undetected unless systems are in place to identify and manage it," she explained.

HIQA called for four key areas of improvement to help tackle this issue:
-All hospitals should have a nutrition steering committee in place
-All admitted patients should be screened for malnutrition
-Hospitals must audit compliance with all aspects of a patient's nutritional care and share these findings with all relevant staff
-Hospitals should try to improve patients' experiences of hospital food and drink by engaging with patients about choice and variety.