Encouraging, assisting and time to EAT: Improved nutritional intake for older medical patients receiving Protected Mealtimes and/or additional nursing feeding assistance

Young, Adrienne; Mudge, Alison; Banks, Merrilyn; Ross, Lynda; Daniels, Lynne

doi:10.1016/j.clnu.2012.11.009

Cited by 69 publications

(162 citation statements)

References 37 publications

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“…The physician had "insider" status from work on the target ward, providing credibility among clinicians, and had subject expertise related to previous research. [20][21][22][23] The physiotherapist was an "outsider" to the ward with credibility related to her organizational position, and developed trust by being accessible to clinicians and responding promptly to concerns.…”

Section: Planning the Interventionmentioning

confidence: 99%

Eat Walk Engage

2013

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High-quality, efficient health care for older patients is a priority for health care systems. Acute Care for Elders units improve outcomes but there is a need for generalizable models of care that adopt the principles pioneered in these units. This report describes Eat Walk Engage, a collaborative care model on a general medical ward in Brisbane, Australia. The model focused on early mobilization, feeding assistance, and cognitive stimulation. Using the Promoting Action on Research Implementation in Health Services implementation framework, the facilitation team enabled the clinical team to recognize barriers and develop solutions. Challenges included unclear responsibility, workload concerns, and risk aversion. Implementation strategies included engaging champions, education, audit and feedback, task delineation and delegation, improving physical resources, and workforce redesign. During the first 18 months, audits showed improved nursing documentation in targeted domains and improved performance of mobilizing and cognitive strategies; length of stay for older inpatients fell by 3 days on the intervention ward.

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Section: Planning the Interventionmentioning

confidence: 99%

Eat Walk Engage

2013

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“…Choice of dishes at each meal, but also choice of more than one course at each eating occasion is recommended to maximise opportunities to optimise food & nutrient intakes and reduce food fatigue [25]. Factors such as protected or managed mealtimes and what this actually means for different hospitals needs to be considered as this can mean greater provision of assistance with eating and drinking [54], although training and targeted support across all eating occasions (not just main meals) can reduce numbers with poor intakes [54,55] as well as increasing greater awareness and monitoring of patients food intakes.…”

Section: Discussionmentioning

confidence: 98%

Dietary intakes in geriatric orthopaedic rehabilitation patients: Need to look at food consumption not just provision

et al. 2016

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“…trained volunteers [32], nursing assistants [33] or healthcare students [34]). Intervention wards will be provided with a half-time trained multi-professional healthcare assistant, who will undertake self-directed tasks (e.g.…”

Section: Methodsmentioning

confidence: 99%

CHERISH (collaboration for hospitalised elders reducing the impact of stays in hospital): protocol for a multi-site improvement program to reduce geriatric syndromes in older inpatients

et al. 2017

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BackgroundOlder inpatients are at risk of hospital-associated geriatric syndromes including delirium, functional decline, incontinence, falls and pressure injuries. These contribute to longer hospital stays, loss of independence, and death. Effective interventions to reduce geriatric syndromes remain poorly implemented due to their complexity, and require an organised approach to change care practices and systems. Eat Walk Engage is a complex multi-component intervention with structured implementation, which has shown reduced geriatric syndromes and length of stay in pilot studies at one hospital. This study will test effectiveness of implementing Eat Walk Engage using a multi-site cluster randomised trial to inform transferability of this intervention.MethodsA hybrid study design will evaluate the effectiveness and implementation strategy of Eat Walk Engage in a real-world setting. A multisite cluster randomised study will be conducted in 8 medical and surgical wards in 4 hospitals, with one ward in each site randomised to implement Eat Walk Engage (intervention) and one to continue usual care (control). Intervention wards will be supported to develop and implement locally tailored strategies to enhance early mobility, nutrition, and meaningful activities. Resources will include a trained, mentored facilitator, audit support, a trained healthcare assistant, and support by an expert facilitator team using the i-PARIHS implementation framework. Patient outcomes and process measures before and after intervention will be compared between intervention and control wards. Primary outcomes are any hospital-associated geriatric syndrome (delirium, functional decline, falls, pressure injuries, new incontinence) and length of stay. Secondary outcomes include discharge destination; 30-day mortality, function and quality of life; 6 month readmissions; and cost-effectiveness. Process measures including patient interviews, activity mapping and mealtime audits will inform interventions in each site and measure improvement progress. Factors influencing the trajectory of implementation success will be monitored on implementation wards.DiscussionUsing a hybrid design and guided by an explicit implementation framework, the CHERISH study will establish the effectiveness, cost-effectiveness and transferability of a successful pilot program for improving care of older inpatients, and identify features that support successful implementation.Trial registration ACTRN12615000879561 registered prospectively 21/8/2015.

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Encouraging, assisting and time to EAT: Improved nutritional intake for older medical patients receiving Protected Mealtimes and/or additional nursing feeding assistance

Cited by 69 publications

References 37 publications

Eat Walk Engage

Eat Walk Engage

Dietary intakes in geriatric orthopaedic rehabilitation patients: Need to look at food consumption not just provision

CHERISH (collaboration for hospitalised elders reducing the impact of stays in hospital): protocol for a multi-site improvement program to reduce geriatric syndromes in older inpatients

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