Questionnaire for fluid intake

We are continually looking to improve nutrition and fluid intake in our hip fracture patients, and would be very grateful for your views. Please cold you take the time to complete the following confidential questionnaire, and return it to a member of staff or place in the questionnaire box.

1. Do you understand the problems that can be associated with poor fluid intake Y/N (please circle)Please list-

2. How much fluid do you think you should take in a day?

3. Do you feel your relative has taken enough fluid in a day?Y/N (Please Circle)

4. Do you think the staff have encouraged your relative to drink Y/NPlease state how-

5. Have staff approached you to encourage your relative to drink fluid Y/N (Please circle)

6. What do you think of the red jug scheme

7. How do you think the red jugs have helped your relative