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Cited by 21Dietetics, Nutrition, and EducationClinical Nutrition and GastroenterologyNutrition and Health in Aging

Improving Nutrition Care, Delivery, and Intakes Among Hospitalised Patients: A Mixed Methods, Integrated Knowledge Translation Study

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Roberts, Shelley, Williams, Lauren T., Sladdin, Ishtar, Neil, Heidi, Hopper, Zane, Jenkins, Julie, Spencer, Alan, Marshall, Andrea P.·2019·Nutrients
DOI 10.3390/nu11061417PMC PMC6627537
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Abstract

Malnutrition is a common and complex problem in hospitals. This study used an integrated knowledge translation approach to develop, implement, and evaluate a multifaceted, tailored intervention to improve nutrition care, delivery, and intake among acute medical inpatients. This observational, pre-post study was conducted in a medical ward at a public hospital in Australia. The intervention was co-developed with key stakeholders and targeted three levels: individuals (nutrition intake magnets at patient bedsides), the ward (multidisciplinary hospital staff training), and the organisation (foodservice system changes). Observational data were collected pre- and post-intervention on patient demographics, food intakes, and the mealtime environment. Data were entered into SPSS and analysed using descriptive and inferential statistics. Ethical approval was gained through the hospital and university ethics committees. A total of 207 patients were observed; 116 pre- and 91 post-intervention. After intervention implementation, patients’ mean energy and protein intakes (in proportion to their estimated requirements) were significantly higher and the number of patients eating adequately doubled (p < 0.05). In summary, a multifaceted, pragmatic intervention, tailored to the study context and developed and implemented alongside hospital staff and patients, seemed to be effective in improving nutrition practices and patient nutrition intakes on an acute medical ward.

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  • In a controlled trial of older female patients, there was no difference in energy or protein intake with the implementation of mealtime volunteers.

    “Where a controlled trial found no difference in the energy or protein intake of older female patients with the implementation of mealtime volunteers, volunteers were as effective as ward nursing staff in providing appropriate feeding assistance.”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [161]

    The Discussion (section 4; page unavailable) reports that most cited protected-mealtime or feeding-assistance studies found no effect on energy and protein intakes. It does not identify a controlled trial of older female patients using mealtime volunteers or compare volunteers with ward nursing staff. The Methods (section 2.4; page unavailable) describe this paper’s intervention as staff training and foodservice changes, not mealtime volunteers. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

  • A combination of organizational changes may be sustained over a period of time and culminate in improved dietary intake.

    “These three studies suggest that a combination of organizational changes may be sustained over a period of time and culminate in improved dietary intake (Level of Evidence 2þ).”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [161]

  • In a cohort study of 207 adult acute medical patients, the number of patients achieving adequate energy and protein intake increased significantly from pre-intervention to post-intervention after multiple nutrition improvement initiatives.

    “The number of patients achieving adequate energy and protein intake increased significantly from pre-intervention to post-interventional.”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [161]

  • The use of conceptual frameworks to implement changes has been successful in some studies.

    “The use of conceptual frameworks to implement changes has been successful in some studies [161,162].”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [161]

  • Mealtime volunteers may be successfully implemented to release nursing staff to carry out other clinical tasks.

    “This suggests that mealtime volunteers may be successfully implemented to release nursing staff to carry out other clinical tasks [161] (Level of Evidence 1þ).”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [161]

    The Methods (2.4, page unavailable) describe staff training and changes to breakfast service, but not mealtime volunteers. The Results (3.3, page unavailable) discuss nursing interruptions; our copy does not say volunteers were implemented or freed nurses for other clinical tasks. Searches for mealtime volunteers and nursing workload found no passage addressing that claim. (LLM, conf=0.75)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Roberts, S., Williams, L. T., Sladdin, I., Neil, H., Hopper, Z., Jenkins, J., Spencer, A., & Marshall, A. P.
Affiliations
  • Griffith University (AU)
  • Gold Coast Hospital (AU)
Corresponding author
Roberts, Shelley
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2019-06-24
Volume
11
Issue
6
Pages
1417
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu11061417
PMC
PMC6627537
OpenAlex
W2952717527
Cited by
21
References
1
Citations by year
2026: 1 · 2025: 3 · 2024: 2 · 2023: 5 · 2021: 9 · 2019: 1
FWCI
2.73
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Griffith Research Online (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
Gold Coast Hospital and Health Service Private Practice Trust Fund (PPTF2014:Clayton)
Topics
  • Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
Keywords
malnutrition, hospitalized patients, nutrition care, nutrition intake, acute medical inpatients, mealtime environment, energy and protein intake, co-development, knowledge translation
MeSH terms
Aged, Aged, 80 and over, Energy Intake, Diet, Feeding Behavior, Female, Food Service, Hospital, Hospitalization, Humans, Inpatients, Male, Middle Aged, Nutritional Status, Nutritive Value, Patient Care Team, Queensland, Time Factors, Treatment Outcome, Malnutrition, Translational Research, Biomedical, Meals

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