title: Designing a national clinical audit of nutritional care in health and social care settings: consideration and future directions.
abstract: The aim of this review paper is to consider how the principles of clinical audit could be applied to the development of an audit of nutritional care in hospitals and care homes, based on criteria derived from the Essence of Care: Food and Drink. A literature review identified fifteen key papers that included guidance or standards for nutritional care in hospitals or care homes. These were used to supplement the ten factors suggested by the Essence of Care to develop a set of potential audit criteria covering all aspects of the nutritional care pathway including the identification of risk of malnutrition, implementation of nutritional care plans, referral to healthcare professionals for further nutritional assessment and nutritional support strategies. A series of audit tools have been developed, including an organisational level audit tool, a staff questionnaire, a patients' and residents' records audit tool and a patients' and residents' experiences questionnaire. Further issues to consider in designing a national nutritional audit include the potential role of direct observation of care, the use of trained auditors and the scope for including the results of pre-existing local audits. In conclusion, a national audit would need to encompass a very large number of health and care organisations of widely varying sizes and types and a diverse range of people.
authors.affiliation: Diabetes and Nutritional Sciences Division, King's College London, London SE1 9NH, UK. emma.l.parsons@kcl.ac.uk
authors.forename: Emma L
authors.initials: EL
authors.lastname: Parsons
authors.forename: Christine
authors.initials: C
authors.lastname: Baldwin
authors.forename: Joanne
authors.initials: J
authors.lastname: Fitzpatrick
authors.forename: Annemarie
authors.initials: A
authors.lastname: Knight
authors.forename: Jill
authors.initials: J
authors.lastname: Manthorpe
authors.forename: Jane E
authors.initials: JE
authors.lastname: Thomas
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Weekes
authors.forename: Kevin
authors.initials: K
authors.lastname: Whelan
authors.forename: Richard
authors.initials: R
authors.lastname: Wilson
authors.forename: Trevor
authors.initials: T
authors.lastname: Murrells
authors.forename: Aidan
authors.initials: A
authors.lastname: Cassidy
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Griffiths
authors.forename: Peter W
authors.initials: PW
authors.lastname: Emery
mesh_terms: D000368:Aged; D006707:Homes for the Aged / Q000592:standards*; D006761:Hospitals / Q000592:standards*; D006801:Humans; D015596:Nutrition Assessment; D011795:Surveys and Questionnaires; D006113:United Kingdom