Barriers to food intake in acute care hospitals: a report of the Canadian Malnutrition Task Force

Abstract

The present study confirms that barriers to food intake are common in acute care hospitals. This analysis also identifies that specific patient subgroups are more likely to experience food intake barriers. Because self-reported low food intake in hospital was associated with several barriers, it is relevant to consider assessing, intervening and monitoring barriers to food intake during the hospital stay.

To eat or not to eat? Indicators for reduced food intake in 91,245 patients hospitalized on nutritionDays 2006–2014 in 56 countries worldwide: a descriptive analysis

“…Female sex and immobility were the factors that were the second and third most-strongly associated factors with impaired food intake, which pointed toward structural and organizational factors in hospitals, namely food provision (25), portion size (26), choice of portion size, ward activities around mealtimes, and availability of support in association with eating (11). The third sensitivity analysis with the target variable eating more than nothing compared with nothing endorsed this finding: eating nothing did not depend on the sex of the patient.…”

“…The hospital organization of food provision can negatively affect food intake and nutritional status of patients. Such factors include patients' dissatisfaction with meals and mealtimes (11), the unavailability of staff for feeding assistance (12), missed screening routines and planning and monitoring of nutritional care (10), inadequate awareness, and insufficient training of health care personnel (13).…”

More-2-Eat: evaluation protocol of a multi-site implementation of the Integrated Nutrition Pathway for Acute Care

“…This issue is especially of concern for medical patients who are more likely to be malnourished than surgical patients [3,6] and for those over the age of 65 who are more likely to be malnourished than younger patient populations (46% vs. 35% for < 65 years; [7]). Poor food intake is also common and results from multiple factors including poor food quality, food/eating preferences, feeling unwell and other disease side effects, as well as barriers to food intake, such as not being able to access the tray or requiring eating assistance [8,9]. Both poor hospital food intake and malnutrition lead to negative health outcomes including a longer length of stay, readmission, and comorbidities and mortality [3,7,[10][11][12][13][14].…”

“…For example, dietitian consults are typically haphazard [6,17] and standardized nutrition screening programs could ensure that malnourished patients are identified and treated. Patients report many barriers to food intake [18] and effective low-technology solutions could be a feasible way to address these issues. Physician and nurse attitudes, knowledge and nutrition care activities demonstrate that education and training are needed to promote and sustain best practice [14,[19][20][21][22][23][24][25][26][27].…”

Need for the Integrated Nutrition Pathway for Acute Care (INPAC): gaps in current nutrition care in five Canadian hospitals

“…Research has also shown that many patients experience barriers to food intake, such as interrupted meals, or inability to open packages, leading to deterioration of their nutritional status while in hospital [19][20][21]. Unidentified malnutrition on admission and iatrogenic or worsening of malnutrition increases length of stay and also affects patients after discharge, including an increased likelihood of readmission [3,11,19,22,23].…”