The Royal College of Nursing has developed a tool kit as part of its Nutrition Now campaign to assist nurses, healthcare workers, caterers and other service providers with the implementation of good hydration practice and the promotion of the benefits of regular water intake. cooler innovation finds out more about how the document could impact on healthcare in the United Kingdom.
Carbohydrates, fats, vitamins, proteins and minerals. What is missing from this list? It might come as a surprise to some, but water also fits into this group of six basic nutrients. Much is made of the need to ensure that hospital patients are meeting their nutritional requirements through food, but water is often overlooked, which can lead to dehydration among those who are most vulnerable.
The UK National Patient Safety Agency’s (NPSA) national reporting and learning system has cited dehydration as a patient safety issue as medical evidence shows that good hydration can assist in the management of diabetes, as well as helpprevent various ailments, such as pressure ulcers, urinary tract infections, kidney stones, heart disease, low blood pressure, cognitive impairment and poor oral health.
As well as visibly promoting wellbeing and a better quality of life for patients, these benefits can also result in a reduction in medication, less time needed to care for patients suffering from common illnesses and the removal of the higher cost professional involvement that is required to prescribe and administer treatment.
“Encouraging the drinking of fresh water makes good economic sense for healthcare professionals on tight budgets,” reads the Water For Health Hydration Best Practice Toolkit for Hospitals and Healthcare. “It is not often that a healthy option proves to be a cheaper solution, but taking drinking water from the tap is highly cost effective.”
Produced by the Royal College of Nursing and the NHS National Patient Safety Agency, alongside nurses, patient groups, key stakeholders and organisations including Water UK, the document lays bare the health and economic benefits of providing water, as well as the specific advantages of hydration for different groups of people, illnesses and situations.
According to Water UK Chief Executive Pamela Taylor, it is high time to work together to improve people’s access to the fresh, high quality tap water that is already in the hospital infrastructure. “Poor hydration has been acknowledged as a serious problem by the NHS, and this is especially true for older hospitals that have little ventilation and warm, crowded wards,” she said.
“We know that a better hydrated patient often uses fewer medicines, like laxatives, and can heal faster. This toolkit will help the nurses and hospital caterers to understand the health benefits of drinking enough water, and then visibly promote these in the hospital environment.”
The Head of Institute at the Royal College of Nursing believes that hospital staff can play a vital role in ensuring that the toolkit will achieve its best practice aim. “Nurses care deeply about good patient nutrition and hydration, and it is vital for everyone, especially when we are ill,” explained Geraldine Cunningham. “The Royal College of Nursing believes that if we are to make hydration a top priority, then everybody in the workforce, from the catering staff through to Chief Executives will need to play a part. It is fundamental to every nurse to impart health information and facilitate healthcare, and this resource will now help to push forward that belief and directly improve the patient experience.”
For The Patients Association, nurses and hospital caterers know how to present food well to people who are not, but there is insufficient focus on providing well presented water. Its President, Claire Rayner stated: “Patients’ health has to be our number one priority. I would therefore urge all hospitals to adopt the principles of this hydration best practice toolkit, and to reassess the limited water availability that we see for many patients in hospital wards. Water is a basic human need, we are not a third world nation, yet some of our hospital hydration facilities would lead us to believe this.”
A key element of water provision is ensuring that water is presented in an appealing way as taste tests have shown that water is enjoyed when it is served chilled and fresh. The toolkit explains that POU water coolers are an effective way of providingwater as they serve it chilled or at a regular temperature, take away any chlorine tastes, do not run out and do not require the storing, lifting and replenishment of bottles.
It advises that bottle fed machines can cost healthcare providers around £6 for each 19 litre (5 gallon) bottle or around £1,000 a year for each machine, while mains fed coolers would run up a bill of less than 2p for every 19 litres. It also says that fit for purpose coolers are available to healthcare providers at keen commerical rates through the NHS Supply Chain Purchasing and Supply Agency.
“Patients should be given access to fresh tap water throughout the day so that they can drink as often as they wish,” it continues. “Providing options for patients to help themselves is vital. There are many ways to achieve this, including providing regular covered jugs of fresh tap water at bedsides and tables, having mains-fed water coolers at accessible heights, serving water regularly and giving patients their own water vessels.”
The toolkit also features advice about how older people can maintain hydration, how water can reduce cancer risk, and how workers can top up their water levels. A sample menu for providing adequate fluids within healthcare, a water facilities checklist, hydration awareness quiz and hospital water audit are also included. Copies are available from the [Royal College of Nursing website].
Practical tips for encouraging water consumption*
How much water should patients drink?*
According to the toolkit, most professionals agree that people should be drinking eight decent sized glasses a day, which is around 2 litres, while the NHS advises that where clinically appropriate, patients should be consuming 2.5 litres a day. Most people, especially older people, do not drink anywhere near that amount, so mild dehydration is very common. It is therefore vital to encourage patients and staff to increase their water consumption.
*Did you know?
Simply breathing in and out uses more than a pint of water a day. Without water, you would only expect to live for around one week.
Water is the main constituent of the body and forms 50 to 60% of body weight and around 75% of volume. Even in the absence of any visible perspiration, approximately half of water loss occurs through the operation of our lungs and skin.
The Thirst 4 Life hydration initiative undertaken by Buckinghamshire NHS and Buckinghamshire County Council led to a 45% reduction in A&E attendances at Wycombe General Hospital from nursing and residential homes between November 2004 and March 2005.
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