Does additional feeding support provided by health care assistants improve nutritional status and outcome in acutely ill older in-patients?—a randomised control trial

Hickson, Mary; Bulpitt, Christopher J.; Nunes, Maria Inês; Peters, Ruth; Cooke, Jonathon; Nicholl, Claire; Frost, Gary

doi:10.1016/s0261-5614(03)00090-6

Cited by 95 publications

(138 citation statements)

References 20 publications

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“…While food intakes were increased in the intervention group, there was no difference in nutritional status, length of stay, grip strength or mortality. The researchers concluded that the use of specialised assistants, without changes to food provision, or the targeting of higher risk patients had limited impact, but did emphasise that the intervention may be better suited to a longer stay setting (Hickson et al 2004).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2008

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Malnutrition is prevalent in elderly hospitalised patients and has been associated with longer lengths of stay (LOS), higher rates of complications and increased hospital costs. Feeding assistance has traditionally been the role of nurses, however with an ageing population and an ever-increasing workload there may not be sufficient time to ensure the nutritional care of all patients. A program in which trained volunteers assist, socialise and feed nutritionally vulnerable patients at lunch on weekdays has been initiated in a major suburban hospital in Sydney. The pilot study reported here aimed to evaluate the lunchtime assistance program in terms of dietary intakes by comparing data from weekdays (with volunteers) and that from weekends (no volunteers). Nine patients (mean age+(SD): 89±4.6 years) participated in the study. Observations and weighed plate waste were recorded for each patient at lunch on two weekdays and two weekend days. When volunteers were present, the average protein intake increased by 10.1 g at lunch (p<0.05) and 10.7g over the whole day (p<0.05). There was also a trend to increased energy intake. Observations indicated that the volunteers, when compared to the nurses, socialised more with patients, encouraged them to eat more often and spent more time feeding them. Trialing volunteer assistance in a larger study would be useful. Observations and weighed plate waste were recorded for each patient at lunch on two weekdays and two weekend days. When volunteers were present, the average protein intake increased by 10.1 g at lunch (p<0.05) and 10.7g over the whole day (p<0.05). There was also a trend to increased energy intake. Observations indicated that the volunteers, when compared to the nurses, socialised more with patients, encouraged them to eat more often and spent more time feeding them. Trialing volunteer assistance in a larger study would be useful.

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Section: Introductionmentioning

confidence: 99%

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

et al. 2008

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“…Although no significant differences were found, a trend towards a greater energy intake (5410kJ compared to 5780kJ) and protein (47g to 50g) was found. 11 Other points of difference are that seven out of the eight patients in the current study were on a texture modified diet. Research has shown that it is harder for patients on a texture modified diet to meet their energy requirements, and that targeted volunteer feeding assistance can be particularly effective in increasing intakes of patients on texture modified diets.…”

Section: Discussionmentioning

confidence: 85%

“…This issue was not faced by a previous international study as they employed feeding assistants. 11 Their randomised control trial (with 592 patients) was carried out in three acute elderly wards at a hospital in London and the paid assistants worked five days a week, and were present at two meals per day. Although no significant differences were found, a trend towards a greater energy intake (5410kJ compared to 5780kJ) and protein (47g to 50g) was found.…”

Section: Discussionmentioning

confidence: 99%

“…10 A study investigating the impact of paid feeding assistants on the nutritional intake of acutely ill older inpatients reported a trend towards increasing nutritional intake in patients receiving feeding assistance. 11 Several Australian studies have evaluated a volunteer feeding program and its effects on energy and protein intakes of elderly hospitalised patients. [12][13] Significantly more protein was consumed when volunteer assistance was given, and there was a trend towards increased energy intakes.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of a pilot volunteer feeding assistance program: Influences on the dietary intakes of elderly hospitalised patients and lessons learnt

Huang

Dutkowski

Fuller

et al. 2015

The Journal of nutrition, health and aging

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K. (2015). Evaluation of a pilot volunteer feeding assistance program: Influences on the dietary intakes of elderly hospitalised patients and lessons learnt. Journal of Nutrition, Health and Aging, 19 (2), 206-210. Evaluation of a pilot volunteer feeding assistance program: Influences on the dietary intakes of elderly hospitalised patients and lessons learnt AbstractObjectives Malnutrition is a serious concern in hospitals and is known to be associated with increased complications for patients, increased hospital costs and length of stay. Trained volunteers that assist 'at risk' and malnourished patients at lunch meals have been shown to effectively increase nutritional intake in a suburban hospital in Sydney. The pilot study reported here aimed to evaluate and share learnings from a similar, newly implemented program, comparing energy and macronutrient intakes on days with no volunteer assistance, to days with volunteers. Design Dietary intakes were determined by visual estimation of meal trays before and after meals, for two days without volunteers, and two days with volunteer assistance at lunch. Macronutrient and energy intakes were compared and data such as weight, height, diet type and medical history were obtained from medical records. Questionnaires were completed by nurses and volunteers in regards to their views and experiences with the program. Setting Hospital based. Results Eight patients (83±4.5 years) participated in the study. When volunteers were present at lunch, the average macronutrient and energy intakes increased, though not statistically significantly. The mean increases were 316kJ (p=0.175) for energy, 3.1g (p=0.468) for protein, 1.4g (p=0.418) for fat and 11.6g (p=0.084) for carbohydrates. Nonsignificant increases in macronutrients were also noted for the average daily intakes. Conclusion Although not statistically significant, energy and macronutrient intakes increased when volunteers were present. The implementation of a volunteer feeding assistance program is one strategy to assist dietary intakes but requires a ready team of volunteers, training, acceptance and significant time to develop. AbstractObjectives: Malnutrition is a serious concern in hospitals and is known to be associated with increased complications for patients, increased hospital costs and length of stay. Trained volunteers that assist 'at risk' and malnourished patients at lunch meals have been shown to effectively increase nutritional intake in a suburban hospital in Sydney. The pilot study reported here aimed to evaluate a similar, newly implemented program, comparing energy and macronutrient intakes on days with no volunteer assistance, to days with volunteers.Design: Dietary intakes were determined by visual estimation of meal trays before and after meals, for two days without volunteers, and two days with volunteer assistance at lunch. Macronutrient and energy intakes were compared and data such as weight, height, diet type and medical history were obtained from medical records. Questionnaires were completed b...

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“…This approach, however, was less effective in an acute hospital setting (26) . In this randomised controlled trial, health-care assistants who were given specific training, identified patients at nutritional risk, planned care and provided assistance with feeding.…”

Section: Feeding Assistancementioning

confidence: 99%

Improving the dietary intake of frail older people

Leslie

2011

Proc. Nutr. Soc.

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As a population subgroup, older people are more vulnerable to malnutrition especially those who are institutionalised. Recognition of deteriorating or poor nutritional status is key in reversing the effects of undernutrition and reinforces the value of regular weight checks and/or the use of screening tools. Commercially produced supplements are often the first option used to address undernutrition in both acute and community settings. They can be expensive and, although regularly prescribed, have undergone only limited evaluation of their effectiveness in community settings. An alternative but less researched approach to improve the nutritional status of undernourished people is food fortification. This approach may be particularly useful for older people, given their often small appetites. The ability to eat independently has been significantly related to decreased risk of undernutrition. Assisting people who have difficulty feeding themselves independently should become a designated duty and may be crucial in optimising nutritional status. Lack of nutrition knowledge has been identified as the greatest barrier to the provision of good nutritional care. Education and training of care staff are pivotal for the success of any intervention to address undernutrition. The development of undernutrition is a multi-factorial process and a package of approaches may be required to prevent or treat undernutrition. Nutrition must be at the forefront of care if national care standards are to be met.

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Does additional feeding support provided by health care assistants improve nutritional status and outcome in acutely ill older in-patients?—a randomised control trial

Cited by 95 publications

References 20 publications

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

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

Evaluation of a pilot volunteer feeding assistance program: Influences on the dietary intakes of elderly hospitalised patients and lessons learnt

Improving the dietary intake of frail older people

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