Has the new All Wales Nutrition and Catering Standards for Food and Fluid for Hospital Inpatients improved the service? Patient survey.
Cardiff Metropolitan University
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Background: Adherence to standards in nutrition and catering in a hospital inpatient setting has not been extensively studied, which poses questions on the status of current services. Aspects including large scale catering, varying dietary needs and financial constraints emphasise the complexity of ensuring all patients receive their daily requirements of food and fluid. This study aimed to survey hospitalised patients to obtain their opinions on food and fluid provision, and thus determine whether the new All Wales Nutrition and Catering Standards for Food and Fluid for Hospital Inpatients has improved the service. Method: This pre-post study design uses a questionnaire to assess patients’ opinions towards meal choice, quality and satisfaction of food and fluid provision. Questionnaires were distributed across all Health Boards and one National Health Service Trust in Wales in 2013, and repeated in 2015 to monitor the implementation of standards. Results: A total of 68% and 54% of questionnaires were returned pre-post study with improved response rates when research was dietetic-led. At baseline, findings were variable across aspects of food and fluid provision with few consistent trends between Health Boards and Trusts. Food choice was of a high standard with statistically significant improvements at lunch (p= 0.000012) and evening meal (p = 0.000011) post-study. Food quality was satisfactory with no statistical differences found (p = 0.431). Fluid provision was of a surprisingly poor standard with insignificant findings (p = 0.580). Snack provision post evening meal was also of a poor standard at baseline but showed statistically significant improvements post-study (p = 0.001). Despite the above, overall satisfaction significantly improved post-study (p = 0.013). Observational findings demonstrate satisfaction is likely to be influenced by an a la carte menu type, and less in conventional food production. Conclusions: Findings were consistent with previous research that food and fluid provision is complex. A statistically significant improvement in patient satisfaction post-study demonstrates the success of the new All Wales Standards, influenced mainly by food choice and improved snack provision. Based on the findings recommendations have been made to focus future research on improving snack provision, fluid provision and food quality, considering food service systems and how these relate to satisfaction.
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