Completion of Menu Cards - Standard Operating Procedure

NHS Borders clinical guidelines
NHS Borders

Introduction

NHS Borders recognises that food, fluid and nutrition are fundamental to health and wellbeing, and therefore to quality and safety in healthcare.

It is essential that patients receive meals that meet their individual dietary requirements including their eating and drinking likes, dislikes, food allergies and therapeutic diet specifications. Any cultural / ethnic / religious needs must also be taken into account.

To ensure this happens, patient menus must be completed fully and accurately and checked before they are forwarded to the Catering Team for preparation of meals.

All multi-disciplinary staff are responsible for adhering to this Standard Operating Procedure (SOP) and ensuring safe nutritional care and adequate hydration.

Purpose/Intent

The purpose of this SOP is to provide instruction on how to complete patient menu cards in adult inpatient areas within Borders General Hospital (BGH) to reduce the risk of patients receiving inappropriate or unsafe meals.

This document is intended to be used in conjunction with the NHS Borders Food, Fluid and Nutritional Care Policy.

Procedure

Patients’ food, fluid and nutritional needs must be communicated to every member of the ward team every shift and when any changes arise. This should be included in the patient handovers and/or written safety brief as routine and documented where appropriate

The staff handover/safety brief will include information on those patients who:

  • require therapeutic diets, food or drink modifications or have particular food requirements e. high calorie/high energy, gluten free, oral nutritional supplements, restricted foods
  • have dysphagia (eating and swallowing problems)
  • are nil by mouth
  • have food allergies
  • require a Food Intake Chart
  • require adapted cutlery
  • require assistance with eating/drinking

The person in charge of the ward will identify at least one appropriate Ward Meal Coordinator (for the day/shift). This person may be of any discipline and any band but must not be a Volunteer.

The Ward Meal Coordinator will ensure that:

  • all staff on the ward are aware of the practice of completing menu cards and are encouraged to adhere to this procedure

  • all patient menus are completed for the following day as the per the procedure outlined below:

    • when the blank patient menu cards arrive from the kitchen in the morning, the Ward Meal Coordinator will assign at least one appropriate member of the ward team to assist in their completion
    • staff member will use the handover/safety brief to inform the needs of each patient, ensuring that the correct menu card is chosen and then completed accurately
    • staff member will check to see if there have been any changes to food/fluid recommendations
    • staff must choose the correct menu card for each patient:

      • yellow dysphagia menu for modified diets (see International Dysphagia Diet Standardisation Initiative (IDDSI) Framework below), (IDDSI -Complete Framework iddsi.org)
      • white standard menu for all other diets including high calories/high energy, healthier choice, vegetarian options and those modified for therapeutic and allergy needs (g. gluten free, dairy free, nut free, low potassium, low residue)
      • please check Adult Inpatient Record (AIR) for written updated documentation from Speech and Language Therapists (SLT) including IDDSI Level.

    • each menu will need to have three meals (per card) marked with:
      • the name of the patient
      • the ward name/number
      • large portion / small portion
      • a diet label (where available)
      • other dietary requirements and/or allergies must be hand-written

    • wherever possible menu cards will be completed with the involvement of the patient, their relative or carer

    • completed menu cards are then collected and checked by the Ward Meal Coordinator, using the handover/safety brief, to confirm:
      • the correct number of menus have been competed to cover all patients
      • the menu card is fully completed
      • meal choices are suitable for the patient’s dietary requirements and allergens and ensure a label or handwritten note has been added where necessary
      • patients requiring modified texture meals have ordered correct textured options on a yellow menu card

    • menu cards are placed on the appropriate meal trolley to be returned to the kitchen

    • when the ward receives their meal trolley they must check that the number of meals ordered have arrived. The Catering Team must be contacted if there are any discrepancies

    • meals should be checked as they are removed from the trolley to ensure that the items delivered match the menu cards and are appropriate and safe for the patient to consume

    • in the event of any menu card having been partially or incorrectly completed, this must be reported to the Senior Charge Nurse of the ward
    • it is expected that the Senior Charge Nurse will report this via NHS Borders electronic adverse event recording system. The Senior Charge Nurse will be required to investigate how any errors occurred and discuss these with the Ward Meal Coordinator responsible on that day/shift

Editorial Information

Last reviewed: 29/02/2024

Next review date: 28/02/2027

Author(s): Spence Z.

Version: 2

Author email(s): zoe.spence@nhs.scot.

Approved By: Food Fluid & Nutrition Group 02/2024

Reviewer name(s): Food Fluid & Nutrition Group, Spence Z.