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Summary
Malnutrition in hospitals is an ongoing international issue. Research indicates that there are many barriers to nutritional care, including lack of nursing time, knowledge and understanding. The Chelsea and Westminster Hospital NHS Foundation Trust runs an annual audit on standards of nutritional screening and subsequent care. To fulfil the organisation's objective of focusing on patient safety and quality of care, the hospital has developed a multidisciplinary approach to malnutrition that includes using volunteers as dining companions.
Keywords
Diet and nutrition; Malnutrition; Volunteers
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NUTRITION IN HOSPITALS is often discussed in the context of undernutrition and is still a concern despite more than 30 years elapsing since the subject was brought to national attention (Butterworth 1974, Bistrian et al 1976, Hill et al 1977). Malnutrition in hospitals has severe clinical implications and remains a significant cost to the NHS (British Association of Parenteral and Enteral Nutrition (BAPEN) 2003, Elia et al 2005).
The independent health watchdog in England, the Care Quality Commission (CQC), assesses all hospitals annually. Compliance with core standard C15 in Standards for Better Health (Department of Health (DH) 2006) is part of the annual performance rating (Box 1 ). It is, therefore in hospitals' interests to provide food services of a high quality. The Chelsea and Westminster Hospital NHS Foundation Trust's internal inspectors, who are members of the patient environmental action team, regularly inspect the food service. The trust was found to be 'excellent' for quality of services and use of resources by the CQCs predecessor, the Healthcare Commission, in October 2007. It was in the top 5 % of the NHS trusts and the top 4% in London that scored 'excellent' for both ratings (Chelsea and Westminster Hospital NHS Foundation Trust 2007) .
Malnutrition
Malnutrition has been defined as 'a state in which a deficiency of nutrients such as energy, protein, vitamins and minerals causes measurable adverse effects on body composition, function or clinical outcome' (National Institute for Health and Clinical Excellence (NICE) 2006)....