The efficacy of protected mealtimes in reducing mealtime interruptions and improving mealtime assistance in adult inpatients in an Australian hospital

摘要

Background/objectives: A Protected Mealtimes Programme (PMP) encourages staff, volunteers and visitors to assist patients and cease non-urgent clinical activity during mealtimes. Given the limited evidence available establishing the efficacy of PMP, we compared mealtime interruptions, mealtime assistance received and nutrient intakes before and after PMP implementation in adult inpatients on acute wards. Subjects/methods: Data collected on patients at main meals before and after PMP implementation included the following: diet code, level of assistance required and received and by whom, time available to consume the meal, position of the patient and tray during eating, type of interruption and by whom and proportion of foods and drinks consumed. Outcomes pre- and post-PMP implementation were compared using χ2, independent samples t-tests and logistic regression analyses. Results: Over two years, 1632 inpatient mealtime observations were conducted (65 (18) years, 51% M). Similar proportions of patients received mealtime assistance when required (～84%, P=0.928). Feeding assistance nearly doubled post-PMP implementation (15-29%, P=0.002). Interruptions by nursing staff increased by 8% post-PMP implementation (P0.001) and represented 61% of all interruptions. Interruptions were less likely to occur pre-PMP implementation (odds ratio, 0.403, 95% confidence interval, 0.301-0.539). Mealtime energy and protein intakes were not changed post-PMP (P=0.979, P=0.482, respectively). Conclusions: The PMP increased nursing staff availability at mealtimes and feeding assistance, but also increased mealtime interruptions. This may explain the lack of change in patient energy and protein consumption. Strategies promoting adherence with PMP implementation, such as nurse ward champions or nursing staff driving PMP implementation, may be required to maximise the benefits of protected mealtimes.