The role of the ward-based nutritional assistants at Harrogate and District NHS Foundation Trust, funded from ward budgets, has been introduced to improve the standard of nutritional care on six acute hospital wards (including two older people’s care wards).
Care plans included food record charts, a “red tray” system (to make nurses more aware of the nutritional needs of the patient), use of nutritional supplements / fortified snacks and dietetic referrals. An internal audit into nutritional screening in 2008 had found that nutritional care plans had not been followed consistently. Patients had not been weighed regularly. Wards with nutrition assistants had been shown to achieve more positive results than those without.
Nutrition Assistants have been introduced to focus solely on nutritional care on wards. Their duties include weighing patients, liaison with catering, assisting with meals, one-to-one care, nutritional screening and implementing nutritional support on wards.
A later internal audit in 2009 evaluated the impact on nutritional care following the introduction of nutrition assistants on two acute wards which had performed below average in the previous audit. It indicates that the introduction of nutrition assistants improves the incidence and frequency of screening to a level of 100 per cent. Patients receive the appropriate nutritional interventions consistently and those requiring specialist assessment are referred to the dietetic department. All at-risk patients are weighed weekly. The hospital follows a protected mealtime protocol. Volunteers are used where appropriate.
Suarez, P. and Farrington-Douglas, J. (2010). Acute awareness: improving hospital care for people with dementia. London: The NHS Confederation, 2010.