Protected Mealtimes in hospitals and nutritional intake: Systematic review and meta-analyses

Porter, Judi; Ottrey, Ella; Huggins, Catherine E.

doi:10.1016/j.ijnurstu.2016.11.002

Cited by 35 publications

(31 citation statements)

References 18 publications

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“…Consequently, there have been ongoing calls for greater healthcare team engagement and collaboration in nutrition care (Bell et al, 2018;Stone, 2013). Efforts to achieve this have included novel models of care addressing organizational culture (Tappenden et al, 2013) and interventions, such as protected mealtimes (Porter, Ottrey, & Huggins, 2017). What remains unclear is the nature of the relationship between staff from different professions who provide meals to hospital patients, whether there is a desire to work together at mealtimes, and how this influences nutrition care.…”

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confidence: 99%

Ward culture and staff relationships at hospital mealtimes in Australia: An ethnographic account

Ottrey

Porter

Huggins

et al. 2018

Nursing & Health Sciences

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Nutrition care is a fundamental component of quality health care provided to patients in hospital, yet little is known about the staff who deliver this care and their interrelationships, and how this impacts nutrition care. In this ethnographic study on two subacute wards, 67 h of fieldwork was conducted over 3 months to explore the relationships, roles, and responsibilities of those involved at mealtimes, and the influence on meal provision. Data were analyzed inductively and thematically. Three themes describing ward culture and staff relationships emerged: (i) defining mealtime roles and maintaining boundaries; (ii) balancing the need for teamwork and having time and space; and (iii) effective communication supports role completion and problem solving. Lack of appreciation of workflow enablers and barriers degraded working relationships between staff with and without central roles at mealtimes. The present study informs health-care organizations on building a culture that supports interprofessional collaboration in nutrition care in the subacute setting. All staff need to be aware of their and others' mealtime roles and responsibilities to support a coordinated approach.

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confidence: 99%

Ward culture and staff relationships at hospital mealtimes in Australia: An ethnographic account

Ottrey

Porter

Huggins

et al. 2018

Nursing & Health Sciences

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“…Mealtime strategies and interventions designed to improve food intake and nutritional status have been investigated in hospital settings (Porter, Haines, & Truby, 2017;Roberts et al, 2014;Wright, Hickson, & Frost, 2006). However, published reviews have found limited success (Cheung, Pizzola, & Keller, 2013;Green, Martin, Roberts, & Sayer, 2011;Porter, Ottrey, & Huggins, 2017;Whitelock & Aromataris, 2013). Paying more attention to mealtime environment and practice may identify opportunities for innovation in nutritional care.…”

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confidence: 99%

“Meal realities” — An ethnographic exploration of hospital mealtime environment and practice

Ottrey

Porter

Huggins

et al. 2017

Journal of Advanced Nursing

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The findings of this study expose the challenges associated with maintaining patient centredness at mealtimes in complex healthcare and foodservice systems. This facilitates a better understanding of why inadequate food intake is difficult to address in the hospital setting and highlights the need to support strategies that approach foodservice processes and nutritional care as complex and non-linear.

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“…Strategies to improve this nutritional intake are of variable success, e.g. protected mealtimes (Porter et al, 2017a;Porter et al, 2017b) and mealtime assistants (Roberts et al, 2014). Furthermore, nutritional guidelines are not necessarily reflected in rehabilitation care pathways for post-ICU patients (Merriweather et al, 2014), with patients experiencing persistent energy and protein deficits that may be pre-existing (Mogensen et al, 2017) and extend throughout the duration of their hospitalization (Chapple et al, 2016).…”

Section: Background and Problemmentioning

confidence: 99%

Oral intake evaluation in patients following critical illness: an ICU cohort study

Jarden

Sutton-Smith

Boulton

2018

Nursing in Critical Care

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Timely and adequate nutrition improves health outcomes for the critically ill patient. Despite clinical guidelines recommending early oral nutrition, survivors of critical illness experience significant nutritional deficits. This cohort study evaluates the oral nutrition intake in intensive care unit (ICU) patients who have experienced recent critical illness. The oral nutrition intake of a convenience sample of ICU patients post-critical illness was observed during a 1-month period. Data pertaining to both the amount of oral nutrition intake and factors impacting optimal oral nutrition intake were collected and analysed. Inadequate oral intake was identified in 62% of the 79 patients assessed (n = 49). This was noted early in the ICU stay, around day 1-2, for most of the patients. A significant proportion (25%) of patients remained in the hospital with poor oral intake that persisted beyond ICU day 5. Unsurprisingly, these were the patients who had longer ICU stays. Critical illness weakness was a factor in the assessment of poor oral intake. To conclude, patients who have experienced critical illness also experience suboptimal oral nutrition. The three key factors that were identified as impacting optimal oral nutrition were early removal of nasogastric tubes, critical illness weakness and poor appetite post-critical illness. Seven key recommendations are made based on this cohort study. These recommendations are related to patient assessment, monitoring, documentation and future guidelines. Future research opportunities are highlighted, including the investigation of strategies to improve the transition of patients' post-critical illness to oral nutrition.

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Protected Mealtimes in hospitals and nutritional intake: Systematic review and meta-analyses

Cited by 35 publications

References 18 publications

Ward culture and staff relationships at hospital mealtimes in Australia: An ethnographic account

Ward culture and staff relationships at hospital mealtimes in Australia: An ethnographic account

“Meal realities” — An ethnographic exploration of hospital mealtime environment and practice

Oral intake evaluation in patients following critical illness: an ICU cohort study

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