4063- Re-Audit Effectiveness of Food and Fluid Chart in KMAH

Background

A baseline audit was undertaken and completed in May 2021 to evaluate the standard of the appropriate use of the food and fluid chart among the patient group (adolescent inpatients) with eating disorders and poor dietary and fluid intake at Kent and Medway Adolescent Unit.

Findings from the baseline audit identified the following:

• Poor documentation in general
• 62% of charts had full names completed
• There was no documentation in 100% of cases in all fluid taken or refused with medicine, additional fluid taken or refused, in daily total signature, urine passed, and bowels opened
• Snack times were poorly documented compared to documentations at main meals (breakfast, lunch, and dinner)
• From the staff questionnaire, although 80% found it easy to complete, this did not reflect in the charts in terms of accurate documentation

Summary of action plan

1. All relevant clinical staff at KMAH to be informed of the audit findings.
2. All relevant clinical staff to be informed of the need to record accurately on the food and fluid charts.

Simpler form to meet needs of patients at KMAH to be designed.

The re-audit was undertaken on 21 May 2021 to establish how effective the implementation and use of the New food and fluid charts is in terms of identifying how reliably the charts are completed after implementing the above actions. In conclusion, the re-audit findings demonstrated the design and implementation of the new Food and Fluid chart that was put in place.

Training of all relevant clinical staff on the need to record food and fluid charts accurately provides evidence to our commissioners that the trust is providing care in line with NICE guidance and CQC Domain, e.g. monitoring fluid balance in people with an eating disorder and improved documentation allows for more effective monitoring and management of a vulnerable group of patients in the Directorate.

Clinical Audit findings have been shared with all relevant clinical staff at KMAH via email and audit presentation. 

The Re- audit findings demonstrated significant improvement in documentation with the implementation on the New food and fluid chart:

Re- audit findings

New chart	Re-audit	Baseline
Full names completed on new charts	93.3%	62%
Dates written on new charts	100%	100%
Signatures completed on new charts	91.7%	62%
Time accurately recorded on new charts	95%	5%

 

Local Audit Quality Review for January 2022

A total of 14 completed report was received on the local programme for quality review, 12 audits has been quality reviewed, and feedback sent to auditor, only 2 audits remain outstanding for quality review.