Hospital mealtimes: action research for change?

Abstract

Poor nutritional care within the hospital setting continues despite decades of work chronicling and measuring the problems. To address the problem changes in practice have been attempted to improve the patients' experience of mealtimes. In order to implement patient-centred mealtimes for older patients by changing the focus from institutional convenience to one that focuses on the requirements of the patients, an action research approach has been used that focuses on action and change, and thus appears to have much to offer those who seek to change practice. The present paper focuses on the first two phases in a three-phase approach. In phase one the nature of everyday mealtime care and the wider context are explored using focus groups, interviews and observations. The data fall into three main themes that all impact on patients' experiences of mealtimes: institutional and organisational constraints; mealtime care and nursing priorities; eating environment. Following feedback of phase 1 findings to staff and identification of areas of concern a model of practice development was selected to guide the change process of the second phase. Changes to mealtime nursing practice and the ward environment have been made, indicating that action research has the potential to improve the mealtime care of patients.

How the professionals can identify needs for improve- ment and improve Food Distribution service for the home-living elderly people in Sweden - an action research project

“…This gave the insight to the fact that the care personnel also needed the information that was provided in the information letters. This knowledge is consistent with results from other studies showing that food preparation and distribution related tasks had a low status and that the personnel who frequently had the responsibility for this service often had a low level of education [1,37] . Even though the 1992 reform was introduced 20 years ago, the municipalities have still not yet resolved the problems of ensuring that those personnel who are involved in the municipal FD service have the correct competence.…”

An exploration of the hydration care of older people: A qualitative study

“…Limited verbal interaction and lack of spontaneous interactions between older people and staff associated with hydration have been reported elsewhere (Ullrich and McCutcheon, 2008). The social aspects of mealtimes in hospital have similarly been described as impoverished (Dickinson et al, 2005). Removing this important dimension contributed to a diminution in the quality of the drinking experience for older people.…”

A volunteer feeding assistance program can improve dietary intakes of elderly patients – A Pilot Study

“…While nurses may view the nutritional care of patients as an important aspect of their job, increased time pressures and competing tasks may mean that they are not able to prioritise feeding above other duties, such as the distribution of medicines at meal times (Kowanko et al 1999;Dickinson, et al 2005). Most research in this area has reported common themes of time restraints and staff shortages.…”

“…Most research in this area has reported common themes of time restraints and staff shortages. Attention by nurses and other staff to patient meal times can have a positive affect on patient eating habits (Dickinson et al 2005;Kayser-Jones & Schell 1997a;Chang et al 2003).…”