Ensuring Patients Are Fed During Procedural Delays: Reflecting on the Past, Addressing the Present, and Building a Better Future

February 2025 | Vol. 69, No. 1
Written by Yasmine Saikali OMS-3, Lake Erie College of Osteopathic Medicine

In hospital settings, it’s all too easy for small oversights to snowball into major issues. One area where this happens far too often is with patient nutrition, particularly when patients are put on “nothing by mouth” (NPO) orders while waiting to see if a procedure, like an endoscopy, will happen that day. If the procedure gets delayed or rescheduled, and no one revisits the diet order, patients can go an entire day—or longer—without being fed. This is not just an inconvenience; it can have serious, even deadly, consequences.

A tragic example of this happened at Poole Hospital in the UK. A 56-year-old man with Down’s syndrome and dementia died after going without food for nine days during his hospital stay. The lack of proper nutrition weakened him to the point that he succumbed to pneumonia. This heartbreaking outcome was entirely preventable and highlights the critical need for better systems to ensure patients don’t fall through the cracks when it comes to basic care like meals.

Here’s how healthcare teams can prevent situations like this from happening in the future:

  1. Automated Systems for Diet Reassessment: Simple alerts in electronic medical records could remind teams to update dietary orders if a procedure gets delayed.
  2. Improve Communication: Ensure that all NPO orders are clearly documented and communicated during every shift. If a procedure is delayed or rescheduled, the team should reassess whether the patient can safely eat until a new plan is confirmed.
  3. Frequent Reassessment: Don’t leave patients on NPO status longer than necessary. If a procedure isn’t happening that day, adjust the order to allow the patient to eat.
  4. Involving Dietitians More: Having dietitians as part of daily rounds could help ensure patients’ nutritional needs aren’t overlooked.
  5. Empower Patients and Families: Patients and their families should feel comfortable speaking up if they notice meals are being missed or if there’s confusion about dietary restrictions. Their voices can be a powerful safety net.

It might seem like a small detail—whether or not a patient gets a meal—but it’s not. Nutrition is fundamental to recovery and survival. The tragedy at Poole Hospital reminds us that we must all stay vigilant, even with the basics. No patient should ever go hungry because of a preventable oversight. By prioritizing communication, collaboration, and frequent reassessment, we can ensure that patients receive the care and dignity they deserve.

BBC News: “Poole Hospital: Man with Down’s syndrome died after going nine days without food.” Link: https://www.bbc.com/news/uk-england-dorset-68251142