"Managing the treatment of a patient in hospital to help reduce costs to the NHS"

I believe the NHS is losing money and could possible delay a patient's departure because it is not managing the nourishment a patient receives.

I was in hospital about in 2001 and a also year ago and I experienced the following issues on both stays in the hospital:

1 - My food tray was left out of my reach and I was unable to access it because I was not mobile as I had just been operated on. The lady who delivered my food tray left quickly before I had chance to ask her to please place the trolley over my bed so I could eat my food. I also noticed the trays for two elderly patients, who were in the same area as me, who were also not mobile, had their food trays placed out of their reach and as a result they did not eat. I noticed the amount of food a person ate or didn't eat was not recorded nor did the staff notice if a patient had had any nourishment.

2- Water jugs were also delivered in the same way as the food tray and placed out of reach of non mobile patients (myself and the two elderly patients). A record of how much water a patient had had was also not made and nor did the staff notice if a patient had had nourishment.

3 - The staff were very business and run off their feet. The bells on the drips would ring during the day and the night. It was difficult to get any sleep as these bells would ring for long periods during the day and the night. The patient's bell next to me rang for over 45 minutes. Her drip was empty for all that time and medication was therefore arriving late. Therefore patients were getting little rest. Lack of sleep can also mean a slower recovery for the patient.

Therefore to conclude:

Without proper nourishment patients recovery could be delayed and they could stay in hospital longer than necessary, which would distress patients and also certainly add extra costs to the NHS. The lack of proper nourishment could contribute to a patients deaths. And as a consequence the NHS could risk negligence claims. In addition, lack of sleep due to drip alarm bells ringing for over 30 minutes per drip, especially at night, can also impact recovery rates due to sleep disturbance. Again a slower patient recover rate increases NHS costs and / or a bed is tied up which another patient could have had.

The improvements I would therefore would suggest are as follows:

1 - Procedures should be put in place in all hospitals to ensure the amount of nourishment a patient has had is recorded or noticed by the staff. A simple way to ensure patients are getting the right nourishment to help them recover to free up a hospital bed would be to record the amount of food and drink a patient has had on the medical chart. Also the reasons why any food and drink has not be taken should be recorded. Staff should take action to ensure patients do get sufficient nourishment or water. And where the patient has difficulty feeding themselves arrangements should be made to assist them. Perhaps a patient care champion can be nominated or employed to ensure patients receive nourishment and fluids. This would be a vital role to aid a quicker recovery.

2 - The delivery of food and water to the patient should involve ensuring the patient can reach the water and place it where they can access it. These people should be seen as providing a vital service to the patient to help aid recovery. They should be more engaged in the care of the patient. It should take very little time for them to check if the patient needs the bed trolley moving to a position where they can reach the food or water.

3 - Drip alarm bells should be dealt with within 5 minutes, especially at night, to minimise the disturbance to patients who are trying to rest to recover. Perhaps some analysis should be carried out to determine the reasons why alarm bells ring for 45 minutes and to determine have this affects the patient to determine the root causes and patient impacts to be determine what action are available.

I am most disappointed there have been no changed in the last 13 years to manage patient nourishment and fluid intake. Also managing sleep disturbances. My fear is that even if you were to increase resources if these issues are not addressed there would be very little change and the NHS would still be loosing an opportunity to improve patient care, and manage costs.