Does presentation of smooth pureed meals improve patients consumption in an acute care setting: A pilot study

Abstract

Aim Malnutrition is a concern across all Australian hospitals and is associated with negative clinical outcomes in up to 60% inpatients, with a further 10% exacerbated by the presence of dysphagia. Providing adequate nutrition for patients requiring a texture‐modified diet often results in meals that look and taste less appealing and which are nutritionally diluted. This article aims is to review change in oral intake using food moulding techniques within an acute care institution for patients on Texture C—smooth pureed meals. Methods This was a 2 week pilot study. Patients were provided smooth pureed lunch either as non‐moulded or a moulded meal. Main meal wastage was weighed and reasons for waste were documented. If patients met the inclusion criteria, a short satisfaction survey was also administered. Results Analysis using a chi‐squared test comparison saw significance in the proportion of patients increasing oral intake from <1/4 meal eaten to >3/4 meal, when in the moulded form (P = 0.03). Median plate waste was reduced by over 100 g in the treatment group but there was no significant change overall. Limited data for patient satisfaction concluded no significance in meal preference. Conclusions The pilot study suggests that using a moulded smooth puree diet can increase mean oral intake and reduce main meal wastage, but a larger sample size is required to demonstrate statistical significance. However, the pilot study effect size (0.55) is large enough to warrant further research interest in this area and results do suggest relevancy in clinical practice for replication.

Texture‐modified diets in aged care facilities: Nutrition, swallow safety and mealtime experience

“…Residents on TMDs have been shown to have lower energy intake and increased risk of malnutrition and are more likely to require feeding assistance compared to residents on regular diets . Increasing mealtime assistance, improving the appearance, taste appeal fortification of TMDs have all been shown to result in improvements to intake and weight for older adults in RACFs . Limited investigation of TMD practice in New Zealand aged care settings provides little guidance to food service and health professionals considering service improvement initiatives.…”

“…[3][4][5] Increasing mealtime assistance, improving the appearance, taste appeal fortification of TMDs have all been shown to result in improvements to intake and weight for older adults in RACFs. 6,7 Limited investigation of TMD practice in New Zealand aged care settings provides little guidance to food service and health professionals considering service improvement initiatives. Typically, dietitians and speech-language therapists provide residentspecific nutritional and swallowing support on request and offer sporadic training.…”

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

“…Hospital malnutrition and decreased food intake present a significant burden for patient outcomes and healthcare costs globally (Agarwal et al, 2013;Corkins et al, 2014;Correia, Perman, & Waitzberg, 2017;Hiesmayr et al, 2009;Khalatbari-Soltani & Marques-Vidal, 2015). Increasing evidence of the prevalence and consequence of hospital malnutrition has prompted the investigation of a wide range of strategies to improve food intake, such as communal dining (Baptiste, Egan, & Dubouloz-Wilner, 2014), puree food moulds (Farrer, Olsen, Mousley, & Teo, 2016), protein-enriched hospital menu (Munk, Bruun, Nielsen, & Thomsen, 2017) and protected mealtimes (Porter, Haines, & Truby, 2017).…”

Challenges in meeting nutritional requirements

“…examined energy and macronutrient intakes in pregnant women and their association with BMI and fasting blood glucose levels. Farrer et al . investigated oral intake of patients requiring texture modified diets.…”

“…Mullaney et al 18 examined energy and macronutrient intakes in pregnant women and their association with BMI and fasting blood glucose levels. Farrer et al 19 investigated oral intake of patients requiring texture modified diets. Patients were provided with a smooth pureed meal in a moulded or non-moulded form.…”