A team of nurses, dietitians and caterers from County Durham and
Darlington NHS Foundation Trust (CDDFT), is launching a new project
to tackle undernutrition and dehydration in patients.
Every ten minutes, someone with malnutrition dies in a UK hospital
. As a result, CDDFT's Nutrition and Hydration Improvement Team is
piloting a new project.
Executive Medical Director, Professor Chris Gray and
patient, Doris Hindmarch.
The project, called 'F4' - 'Focus on Food and Fluid First', will be
trialled in two wards at Darlington Memorial Hospital. It aims to
tackle the problem of undernourishment in patients, helps prevent
them from losing further weight during their stay in hospital, as
well as providing support once they are discharged.
34 per cent of UK patients are malnourished when they are admitted
to hospital. Of these, a high proportion experience a further
decline in nutrition status levels and weight during their stay.
Patients who are malnourished do not recover as well or as quickly
as those with a healthy body mass index, and may require longer or
further stays in hospital as a result.
Patients at risk of undernutrition are often treated with a
prescribed nutritional supplement to help them gain weight, but
many patients have reported disliking the taste. The new campaign
will focus on using foods such as fortified milkshakes, food dishes
and mousses, rather than prescribed oral nutritional supplements,
as treatment for undernutrition. This method is not only preferred
by patients, but is also more cost effective. Some of these
specially fortified foods and drinks will be used for the first
time in a hospital environment as part of the campaign.
Patients will also be provided with extra support at mealtimes
through the introduction of a new volunteer scheme within the
Trust. Any member of CDDFT staff will be allowed to volunteer once
a month to give 45 minutes of their usual working day to support
and encourage patients at mealtimes. Friends and family will also
be encouraged to visit patients at mealtimes to further support the
Once the patient has been released from hospital, they will be
provided with tools to support them. Leaflets on eating to meet
nutritional needs have been developed, and patients who are
discharged home on nutritional supplements will receive a weekly
'health call' - an automated telephone call to monitor their
weight, appetite and compliance in taking their nutritional
supplement. Patients will also be provided with a 'hospital to
home' food parcel, containing staple items such as bread and milk,
to support those who may have had a long stay in hospital and have
no food at home.
All frontline staff will complete full training on the new
nutritional standards during 2014, and the new method will form
part of staff induction.
Rachael Masters, Senior Specialist Dietitian at the Trust, said:
"Undernutrition is a big problem not only in our region but across
the UK, and is one of NHS England's key focuses for 2014, which is
why we need to really focus on making this a priority for our
"The Focus on Undernutrition team here at CDDFT have built up a
strong reputation over the years, and are now recognised as the
UK's flagship service by national organisations. Two members of
CDDFT have been selected to be national ambassadors for
International Nutrition and Hydration Week which is a fantastic
honour and is representative of the great work being done in our
region to combat these important issues. We're really excited to
launch the F4 project, and hope it will be used as an exemplar of
good practice to Trusts across the country."
For more information on the F4 project -
'The treatment I have received from all the staff has been
excellent and could you extend my thanks to them all. A very
thankful and relieved patient'.
Patient, Dermatology Outpatients Department, University Hospital
of North Durham