Exploring staff perceptions and experiences of volunteers and visitors on the hospital ward at mealtimes using an ethnographic approach

Ottrey, Ella; Palermo, Claire; Huggins, Catherine E.; Porter, Judi

doi:10.1111/jocn.14318

Cited by 12 publications

(8 citation statements)

References 46 publications

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“…The present study was part of a larger research project exploring mealtime culture, environment, and social practice from the perspective of staff, volunteers, and visitors in subacute care (Ottrey, Porter, Huggins, & Palermo, ). The contributions of volunteers and visitors have been reported elsewhere (Ottrey, Palermo, Huggins, & Porter, ).…”

Section: Introductionmentioning

confidence: 99%

Ward culture and staff relationships at hospital mealtimes in Australia: An ethnographic account

Ottrey

Porter

Huggins

et al. 2018

Nursing & Health Sciences

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Nutrition care is a fundamental component of quality health care provided to patients in hospital, yet little is known about the staff who deliver this care and their interrelationships, and how this impacts nutrition care. In this ethnographic study on two subacute wards, 67 h of fieldwork was conducted over 3 months to explore the relationships, roles, and responsibilities of those involved at mealtimes, and the influence on meal provision. Data were analyzed inductively and thematically. Three themes describing ward culture and staff relationships emerged: (i) defining mealtime roles and maintaining boundaries; (ii) balancing the need for teamwork and having time and space; and (iii) effective communication supports role completion and problem solving. Lack of appreciation of workflow enablers and barriers degraded working relationships between staff with and without central roles at mealtimes. The present study informs health-care organizations on building a culture that supports interprofessional collaboration in nutrition care in the subacute setting. All staff need to be aware of their and others' mealtime roles and responsibilities to support a coordinated approach.

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Section: Introductionmentioning

confidence: 99%

Ward culture and staff relationships at hospital mealtimes in Australia: An ethnographic account

Ottrey

Porter

Huggins

et al. 2018

Nursing & Health Sciences

Self Cite

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“…There was little social interaction at mealtimes, with no visitors at mealtimes or food brought in by family members observed in this study, revealing how unsocial the dining experience appeared. With benefits of visitors at mealtimes likely to extend beyond dietary intake (Durkin et al., 2014), it is important for psychiatric wards to consider how they can enable visitors to be present at mealtimes within a paradigm of “helpfulness” rather than “hindrance” (Ottrey, Palermo, et al, 2018). Behaviours of wandering and food refusal, such as those observed for Case 8, are common in older people with cognitive impairment, which is highly prevalent but under‐recognized among hospitalized older adults (Inouye et al., 2014) and is an independent predictor of inadequate intake (Mudge et al., 2011).…”

Section: Discussionmentioning

confidence: 99%

Mealtime care and dietary intake in older psychiatric hospital inpatient: A multiple case study

Flint

Matthews‐Rensch

Flaws

et al. 2020

Journal of Advanced Nursing

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Aims To investigate the energy and protein adequacy of meals and dietary intake of older psychiatric inpatients and describe patient and mealtime factors potentially influencing intake. Design Multiple case studies. Methods Psychiatric inpatients aged 65 years and older, admitted to a single mental health ward during the 6‐week study period (April–May 2019) were eligible for inclusion. Dietary intake was observed for two consecutive days each week (minimum four observation days). Visual plate waste methods were used to estimate patients’ dietary intake at mealtimes, with energy and protein intake calculated using known food composition data and compared with estimated requirements. Medical records were reviewed weekly to collect information on potential factors related to intake and mealtime care. Data from all sources were first summarized in a case record for within‐case analysis using descriptive statistics, followed by cross‐case analysis. Results Eight participants (five men, age 67–90 years, two underweight and one overweight, and four requiring some mealtime assistance) had 5–12 days of observation data recorded. Three met their estimated daily energy and protein requirements throughout the study period, while the remaining five participants did not. The main barriers identified as contributing to insufficient energy and protein intake were as follows: missing meals (asleep and treatment); inadequate food provided (insufficiency of the standard hospital menu); and need for increased mealtime assistance. Conclusion Poor dietary intake may be common among older psychiatric patients, suggesting that they may also need nursing and multidisciplinary nutrition care interventions shown to effectively prevent and treat malnutrition in other older inpatient groups. Impact Older psychiatric patients experience similar nutrition and mealtime issues to other older inpatients. This study highlights the need for nurses and the multidisciplinary team to ensure patients order and receive adequate food, especially when they miss meals and that they receive proactive mealtime assistance.

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“…All studies were at high risk of bias for the domain considering the relationship between the participants and the researcher. The qualitative studies (41,52) were judged to be at unclear risk of bias for some domains due to insufficient information within the data collection and participant recruitment methods and a lack of rigour in the overall data analysis. Both studies had a low risk of bias for addressing the study aims, the appropriateness of the qualitative methodology and research design.…”

Section: Quality Of Studiesmentioning

confidence: 99%

“…Twelve of 17 (71%) studies (n = 297 participants from 8 studies, 4 studies did not report sample size), reported on patient, staff, and/or carer experience and satisfaction, including two home-based and nine hospital based summarized in Table 4. All studies used different methods for data collection ranging from observations (43,45,49,52), semi-structured interviews and focus groups (22,41,51,52), validated questionnaire (38) and an unclear methodology (44,46,48,50). Methods used to process data in qualitative studies included an ethnographic approach (52) and thematic synthesis (41).…”

Section: Patient Staff and Carer Experience And Satisfactionmentioning

confidence: 99%

The effectiveness of trained volunteer delivered interventions in adults at risk of malnutrition: A systematic review and meta-analysis

et al. 2021

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Exploring staff perceptions and experiences of volunteers and visitors on the hospital ward at mealtimes using an ethnographic approach

Cited by 12 publications

References 46 publications

Ward culture and staff relationships at hospital mealtimes in Australia: An ethnographic account

Ward culture and staff relationships at hospital mealtimes in Australia: An ethnographic account

Mealtime care and dietary intake in older psychiatric hospital inpatient: A multiple case study

The effectiveness of trained volunteer delivered interventions in adults at risk of malnutrition: A systematic review and meta-analysis

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