Accuracy and adequacy of food supplied in therapeutic diets to hospitalised patients: An observational study

Aim

This study assessed the accuracy (including sources and reasons for errors) and adequacy (of patients' intakes relative to requirements) among patients prescribed therapeutic diets in the hospital setting.

Methods

This observational study was conducted across six wards in a metropolitan tertiary hospital over 14 consecutive days. Meal accuracy was assessed by comparing each individual food or fluid item provided to each patient to items allowed on their specific diet code. Errors were defined by severity (critical or non-critical threat to patient safety) and source (foodservice system, staff or patient). Nutritional adequacy was determined by comparing patients' daily energy and protein intakes to individually estimated requirements. Intakes were considered adequate if consumption was ≥75% of requirements.

Results

Meals of 67 patients (31 females, aged 60.0 ± 19.4 years) were assessed for accuracy for up to two days. Of the total 347 therapeutic meals observed, 69 (19.9%) were inaccurate. A large proportion of these errors were critical (64.8%). Foodservice errors were the most common source. Of the 48 patients with complete dietary intake data, mean energy and protein intakes were 3192 ± 2220 kJ and 33 ± 27 g protein, respectively. Only five and seven patients consumed adequate energy and protein to meet their estimated requirements, respectively.

Conclusion

Patients requiring therapeutic diets during hospitalisation are frequently exposed to food and/or fluid errors that may pose an acute threat to their safety. In addition, prescription of these diets may result in patients being unable to adequately meet their nutritional requirements.

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