Aspects of protected mealtimes are associated with improved mealtime energy and protein intakes in hospitalized adult patients on medical and surgical wards over 2 years

Palmer, Michelle; Huxtable, S

doi:10.1038/ejcn.2015.87

Cited by 25 publications

(33 citation statements)

References 18 publications

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“…Although the KA scores were relatively high for this group, the P scores demonstrate room for improvement. For example, proponents of “protected mealtimes” suggest decreasing mealtime interruptions [27,28,29,30], yet only 35% of M2E hospital staff arrange their tasks to minimize this interruption. Food intake is an important factor for determining length of stay, and 82% agreed/strongly agreed that monitoring food intake was important, yet this was not always done in practice.…”

Section: Discussionmentioning

confidence: 99%

Quality Nutrition Care: Measuring Hospital Staff’s Knowledge, Attitudes, and Practices

et al. 2016

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Understanding the knowledge, attitudes, and practices (KAP) of hospital staff is needed to improve care activities that support the detection/prevention/treatment of malnutrition, yet quality measures are lacking. The purpose was to develop (study 1) and assess the administration and discriminative potential (study 2) of using such a KAP measure in acute care. In study 1, a 27-question KAP questionnaire was developed, face validated (n = 5), and tested for reliability (n = 35). Kappa and Intraclass Correlation (ICC) were determined. In study 2, the questionnaire was sent to staff at five diverse hospitals (n = 189). Administration challenges were noted and analyses completed to determine differences across sites, professions, and years of practice. Study 1 results demonstrate that the knowledge/attitude (KA) and the practice (P) subscales are reliable (KA: ICC = 0.69 95% CI 0.45–0.84, F = 5.54, p < 0.0001; P: ICC = 0.84 95% CI 0.68−0.92, F = 11.12, p < 0.0001). Completion rate of individual questions in study 2 was high and suggestions to improve administration were identified. The KAP mean score was 93.6/128 (range 51–124) with higher scores indicating more knowledge, better attitudes and positive practices. Profession and years of practice were associated with KAP scores. The KAP questionnaire is a valid and reliable measure that can be used in needs assessments to inform improvements to nutrition care in hospital.

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Section: Discussionmentioning

confidence: 99%

Quality Nutrition Care: Measuring Hospital Staff’s Knowledge, Attitudes, and Practices

et al. 2016

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“…Globally, many studies have examined the prevalence of malnutrition [1–5], the barriers to food intake [6–8], and ways to protect mealtimes [9–12] in hospital. Few studies have attempted to describe how to improve hospital nutrition care practices and embed those practices in the unit routine [13].…”

Section: Introductionmentioning

confidence: 99%

Changing nutrition care practices in hospital: a thematic analysis of hospital staff perspectives

Laur

Valaitis

Bell

et al. 2017

BMC Health Serv Res

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BackgroundMany patients are admitted to hospital and are already malnourished. Gaps in practice have identified that care processes for these patients can be improved. Hospital staff, including management, needs to work towards optimizing nutrition care in hospitals to improve the prevention, detection and treatment of malnutrition. The objective of this study was to understand how staff members perceived and described the necessary ingredients to support change efforts required to improve nutrition care in their hospital.MethodsA qualitative study was conducted using purposive sampling techniques to recruit participants for focus groups (FG) (n = 11) and key informant interviews (n = 40) with a variety of hospital staff and management. Discussions based on a semi-structured schedule were conducted at five diverse hospitals from four provinces in Canada as part of the More-2-Eat implementation project. One researcher conducted 2-day site visits over a two-month period to complete all interviews and FGs. Interviews were transcribed verbatim while key points and quotes were taken from FGs. Transcripts were coded line-by-line with initial thematic analysis completed by the primary author. Other authors (n = 3) confirmed the themes by reviewing a subset of transcripts and the draft themes. Themes were then refined and further detailed. Member checking of site summaries was completed with site champions.ResultsParticipants (n = 133) included nurses, physicians, food service workers, dietitians, and hospital management, among others. Discussion regarding ways to improve nutrition care in each specific site facilitated the thought process during FG and interviews. Five main themes were identified: building a reason to change; involving relevant people in the change process; embedding change into current practice; accounting for climate; and building strong relationships within the hospital team.ConclusionsHospital staff need a reason to change their nutrition care practices and a significant change driver is perceived and experienced benefit to the patient. Participants described key ingredients to support successful change and specifically engaging the interdisciplinary team to effect sustainable improvements in nutrition care.Trial registrationRetrospectively registered ClinicalTrials.gov Identifier: NCT02800304, June 7, 2016.

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“…This has been in recognition of the ageing and frail hospital population (Bagshaw et al, 2014;Joosten, Demuynck, Detroyer, & Milisen, 2014), known challenges associated with opening food and beverage packaging and self-feeding in hospital (Bell et al, 2013;Tsang, 2008), and staffs' limited time and resources (Eide, Halvorsen, & Almendingen, 2015;Ross, Mudge, Young, & Banks, 2011). Studies have shown that 31%-52.5% of patients need assistance at mealtimes (Palmer & Huxtable, 2015;Westergren, Karlsson, Andersson, Ohlsson, & Hallberg, 2001;Young et al, 2016). Mealtime assistance programmes aim to improve patients' access to and consumption of meals in hospital by enlisting trained or untrained staff, volunteers and visitors to help patients at mealtimes.…”

Section: Introductionmentioning

confidence: 99%

Exploring staff perceptions and experiences of volunteers and visitors on the hospital ward at mealtimes using an ethnographic approach

Ottrey

Palermo

Huggins

et al. 2018

Journal of Clinical Nursing

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Aspects of protected mealtimes are associated with improved mealtime energy and protein intakes in hospitalized adult patients on medical and surgical wards over 2 years

Abstract: Aspects of protected mealtimes were associated with improved intake. Identifying these achievable aspects during planning and ensuring successful implementation of protected mealtimes may be critical for optimizing acute inpatient intake.

Cited by 25 publications

References 18 publications

Quality Nutrition Care: Measuring Hospital Staff’s Knowledge, Attitudes, and Practices

Quality Nutrition Care: Measuring Hospital Staff’s Knowledge, Attitudes, and Practices

Changing nutrition care practices in hospital: a thematic analysis of hospital staff perspectives

Exploring staff perceptions and experiences of volunteers and visitors on the hospital ward at mealtimes using an ethnographic approach

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